Background: Depressive disorders are among the most frequent psychiatric disorders, accounting for up to 30% of primary care service utilisation in developing countries in general, and Uganda in particular. However, delays in seeking treatment, misdiagnosis and non-specific treatments have compromised appropriate care for people with depression. The general aim of this thesis is to explore and describe how depressive symptoms are conceptualised and communicated by the Baganda and how this conceptualisation may influence their help-seeking behaviour and processes. The research questions that the studies aimed to answer were: i) How do the Baganda understand, talk about and cope with depression? ii) What is perceived as effective treatment and how severe must symptoms be to warrant treatment? iii) Are the sub-types of depression seen as constituting one illness?

Methods: The thesis consists of four exploratory papers employing qualitative methods of individual interviews and Focus Group Discussions. Paper I reports preliminary results of a pilot study on lay explanations of causes, effects and help-seeking behaviour for depression among the Ganda cultural group. Twenty-nine adults participated in four focus group discussions and four individual interviews. Paper II reports results of an interview study among 25 adults receiving treatment for depression, regarding their personal and social meaning of depression, their beliefs on causes and consequences of depression, and what triggered seeking psychiatric help. Paper III reports results of the study that aimed to explore the Baganda’s conceptualization of psychotic depression in terms of illness identity, causes and treatment. Members of the general population participated in 31 individual interviews and 12 focus group discussions. Unlabelled case vignettes based on DSM-IV criteria for psychotic depression were used as stimulants for discussion. Paper IV reports results of a study exploring traditional healers’ explanatory model of depression without psychotic features. Interviews were conducted with 22 traditional healers.