Prevalence of severe mental and neurological disorders in Mozambique: a population-based survey.

BACKGROUND: The scarcity of information about the mental and neurological health of people in Mozambique has hindered policymaking and investment. We aimed to assess the prevalence of seizure disorders, psychoses, and mental retardation in urban and rural Mozambique. METHODS: 2739 households were randomly selected, 1796 of which were in Maputo city and 943 in the rural town of Cuamba. A key informant from each household was asked to identify household members with disorders that matched the descriptions given in case vignettes. Key informants were also asked about causes of disorders, and their treatment, and current state. FINDINGS: Lifetime prevalence rates for all three disorders were higher in rural than in urban settings. Prevalence of psychoses (in adults) was 4.4% in the rural town versus 1.6% in the city (standardised prevalence ratio 2.79); mental retardation 1.9% versus 1.3% (1.48); and seizure disorders 4.0% versus 1.6% (2.00). Of the three disorders, key informants most frequently attributed psychoses to supernatural causes, followed by seizure disorder. In about three-quarters of all cases, households had consulted a traditional medical practitioner. Nearly half the people with these disorders in rural areas were rated as being in poor health. INTERPRETATION: Advocacy to improve understanding of mental disorders; investment in mental-health resources in rural areas; and collaboration with traditional medical practitioners are urgently needed, especially in the poor rural areas of Mozambique.