Abstract
IntroductionIn Nigeria, approximately 4.33 million adults suffer from hypertension and about a third of them do not adhere to prescribed medications. Depression has been reported to significantly predict poor medication adherence. The relationship between medication non-adherence and co-morbid depressive disorder in patients with hypertension has not been adequately explored in this environment. The study aimed to determine the prevalence of depression in patients with hypertension. The association between socio-demographic characteristics and presence of co-morbidity on medication adherence was also determined.MethodsA cross-sectional descriptive research design was adopted for the study. A socio-demographic questionnaire, the modified Morisky Medication Adherence Scale (MMAS), the Hamilton Rating Scale for Depression (HAM-D) and the Mini International Neuropsychiatric Interview (MINI), were administered to four hundred patients with hypertension attending medical out-patient clinic between August and September 2012.ResultsAbout 43% (168) were aged 61 to 64 years the majority being females, with a female to male ratio of 1.63:1. The prevalence of comorbid depression was 22.8%, made up of mild (21.8%) and moderate (1.0%) depressive episodes only. Depression was commoner among females than males in a ratio of 3:1. A majority of the participants (96.8%) had high medication adherence; 2.8% and 0.4% had moderate and low adherence respectively. Depression was more among patients with good medication adherence.ConclusionThe occurrence of mild depressive disorder among hypertensives did not affect the level of medication adherence. Review of Antihypertensive drugs should also be done often to ensure patients are not likely to have depressive illness as a side effect of drugs used.
Highlights
Depression is a very common mental health problem worldwide
The World Health Organization (WHO) estimates that 121 million people currently suffer from depression and that depression will become the second most common cause of disability after heart disease by 2020 [1]
The Lagos study was noted to have excluded participants older than 60 years, an age group known to be vulnerable to developing depressive disorders for myriad psychosocial reasons; and the subgroup of patients who had developed complications from hypertension [20]
Summary
The World Health Organization (WHO) estimates that 121 million people currently suffer from depression and that depression will become the second most common cause of disability after heart disease by 2020 [1]. Depression often co-occurs with chronic physical illnesses such as hypertension, diabetes mellitus and epilepsy [2,3,4]. These chronic physical illnesses sometimes lead to a decrease in the patient's quality of life and increase the risk of developing depression. Cardiac patients appear to be at greater risk of developing depression many years after the initial medical diagnosis is made [5]. Some drugs used in the treatment of hypertension such as methyldopa and reserpine are known to precipitate depression, while some of the drugs used in the treatment of depression like bupropion, venlafaxine and phenelzine have been reported to cause hypertension [7, 8]
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