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Received November 4, 2003; accepted December 19, 2003
The South Africa Stress and Health Study (SASH) is a large psychiatric epidemiological survey that is currently underway in South Africa. It is a part of the World Health Organization's World Mental Health (WMH) 2000 initiative and seeks to complete interviews with a nationally representative sample of 5000 adults. The WMH initiative is obtaining population-based data on the prevalence and severity of specific psychiatric disorders, demographic and psychosocial correlates of these diagnoses, and the levels and adequacy of mental health service utilization. SASH is using the fully structured pencil and paper version of the WHO Composite International Diagnostic Interview (CIDI) to assess lifetime and 12-month rates of mental disorders using both the DSM-IV and the ICD-10 diagnostic systems. In addition, the SASH seeks to collect information on the prevalence of exposure to physical and psychological torture in South Africa and to assess the association between such traumas and specific psychiatric disorders. It will also assess a broad range of risk factors and resources that may modify the association between exposure to human rights violations and mental health.
Key words: Epidemiology; South Africa; torture; psychiatric disorders; mental health services.
INTRODUCTION
Understanding the psychological sequelae of exposure to torture and political violence is an important area of inquiry in the field of mental health (Basogulu et al., 1997; Piwowarczyk et al., 2000) in both the developed and the developing world (Desjarlais et al., 1995). Prior research suggests that individuals who were exposed to torture report elevated levels of physical (Foster, 1987; Goldfeld et al., 1988) and psychological (Basogulu et al., 1997; Niederland, 1981; Van Velsen et al., 1996) health problems. However, while useful, these studies are limited because of selection biases associated with the use of clinical and convenience samples.
The South Africa Stress and Health Study (SASH) has as its primary aim the systematic investigation of this timely and important topic in South Africa. Funded by the National Institutes of Health in the United States and sponsored by the World Health Organization (WHO), the SASH began in 1999 with the aim of interviewing 5000 adult South Africans from all provinces throughout the country to comprise a nationally representative sample. It is the first study of its kind...