Somatic Complaint Syndromes and Depression in Nigeria

Abstract

Up until about three decades ago, depressive illness was thought to be rare among sub-Saharan Africans. Indeed it was at one time believed that Yoruba-Nigerians did not have a word for “depression”. From 1956 onwards however, numerous reports began to indicate that not only does depressive illness occur among Africans, it occurs at high prevalence rates (Smartt, 1956; Lambo, 1960; Field, 1960; Prince, 1968). Savage and Prince (1967) have offered two reasons for this discrepancy. These were that the definition of depression used was excessively narrow, placing too much emphasis on self-accusation and verbalisation of depressive feelings, and secondly that the sample studied were “lunatic asylum” populations. Lambo in 1960 reported that many cases of endogenous depression remained concealed by the label “neurasthenia” and that those diagnosed as intractable psychoneurotics were in fact endogenous depressives. The clinical features of depression in the African included “periodic asthenia, multiple hypochondriacal symptoms of varying degrees of severity, mild but demonstrable sadness of mood, agitation and anxiety, lack of concentration, slight retardation and general mental inertia.” Ideas of self accusation and profound sense of sorrow feature only in terminal stages.