Life events, difficulties and depression among women in an urban setting in Zimbabwe.
BACKGROUND: A previous paper (Abas & Broadhead, 1997) reported that among 172 women randomly selected from a Zimbabwean township 30.8% had a depressive or anxiety disorder during the previous year. Compared with London, the higher annual prevalence of disorders in Harare could mostly be accounted for by an excess of onset cases in the study year (annual incidence of depression 18%). This paper reports on the role of life events and difficulties in the aetiology of depression among these women. METHOD: Randomly selected women (N = 172) from a township in Harare were interviewed with a Zimbabwean modification of the Bedford College Life Events and Difficulties Schedule (LEDS). RESULTS: Events and difficulties proved critical in provoking the onset of depression in Harare. Far more events occurring in Harare were severe or disruptive. Furthermore, a proportion of the Harare severe events were more threatening than have been described in London. As in London, certain types of severe event were particularly depressogenic, i.e. those involving the woman's humiliation, her entrapment in an ongoing difficult situation, or bereavement. However, more severe events in Harare involved these specific dimensions. CONCLUSIONS: Results indicate a common mechanism for the development of depression, as defined by international criteria, between Zimbabwe and London. The high frequency of severe events, and their especially adverse qualities, offer an explanation for the high incidence of depression in Harare.