A classroom survey was conducted in June 1994 among 3061 secondary school students in four provinces in Zimbabwe, with the main objective of measuring health behaviours, school performance and environmental and cultural factors as predictors for drug use. This paper presents an analysis of the relationship between cultural orientation and alcohol use. The survey instrument was based on previous studies undertaken in Zimbabwe and in Europe and adapted to the local situation. A two-staged stratified random sampling strategy distinguished between four different socio-cultural groups. Standardized instructions were given in classrooms by a trained research team. Respondents' mean ages were 14.9 years for boys and 15.1 years for girls, and 51.4% were boys. For a number of core questions, test-retest reliability was shown to be satisfactory. A 14-item scale focusing on language, mass media and music preferences was constructed to measure cultural orientation. Principal component analysis revealed two distinct factors with low interfactor correlation and acceptable scale reliability (alpha), one representing Western orientation and the other Zimbabwean or traditional cultural orientation. Zimbabwean orientation was found to be associated with lower alcohol use, whereas western orientation was associated with higher probability for alcohol use.

The World Health Organization (WHO) Somatoform Disorders Schedule (SDS) is a highly standardized instrument for the assessment of somatoform disorders according to the tenth revision of the International Classification of Diseases (ICD-10) and the fourth edition of the Diagnostic and Statistical Manual (DSM-IV). The SDS was produced in the framework of the WHO International Study of Somatoform Disorders and tested for its reliability in Brazil, India, Italy, the USA and Zimbabwe. A sample of 180 patients from general psychiatry, primary care and general medical settings were interviewed with the SDS within a three-day interval by nonclinician and clinician interviewers. The agreement between the two interviews was tested using the intraclass correlation coefficients (ICC) and kappa statistic. The test-retest reliability of the SDS was found to be very good (the ICC for all the centres was 0.76; overall kappa value for SDS questions was 0.58; one-third of SDS questions had a kappa value of 0.60 or higher). The field test results of the SDS indicated that the instrument may be administered in larger studies by non-clinician interviewers without compromising the ability to document the prevalence of somatoform disorders in different cultures.

This article presents the results of a study of alcoholism among outpatients of a rural district hospital in Kenya. One hundred and twelve outpatients aged 18 years or over attending Kisii District Hospital were interviewed using the alcohol section of the Diagnostic Instrument Schedule (DIS). The participants consisted of 56 males and 56 females. Of these, 54% of the males and 25% of the females met the DIS criteria for alcohol abuse and/or alcoholism. Those classified as alcoholics differed significantly from the non-alcoholics on variables associated with sex, age, past marital state, religion and types of alcoholic drinks consumed. No significant differences were found with respect to present marital state, education, occupation, family size, age of first intoxication or physical illness.

The World Health Organization has recently launched an international study of somatoform disorders in different cultures. Five centres representing distinct cultures participated in phase I of the project, the main objective of which was to test the cross-cultural applicability and reliability of instruments for the assessment of somatoform disorders. The analysis of the assessed somatic symptoms showed that various aches and pains in different parts of the body represented cross-culturally the most frequent symptoms for which there was no medical explanation. Such symptoms may indicate the presence of an underlying mental disorder but can also represent a means for culture-specific expression of psychosocial distress. This bears particular significance for health professionals in primary and general medical care, who are most likely to encounter patients presenting with multiple, persistent and medically unexplained somatic symptoms.

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