Abstract
Background: Depression is common psychiatric disorder among general outpatients. Prevalence of depression and associated factors among this population has been studied in some parts of Nigeria. However, few if any were conducted in the most populous geopolitical zone of Nigeria. Materials & Method: This study determines the prevalence of depression and associated factors among general outpatients. It was a descriptive cross-sectional study. 402 of the 410 participants recruited for the study completed the study. Diagnosis of depression was confirmed using SCAN (Schedule for Clinical Assessment in Neuropsychiatry) ver. 2.1. Severity of depression was rated using HDRS (Hamilton Depression Rating Scale). Result: Two hundred were subsequently diagnosed depressed using SCAN out of 213 who scored HADS cutoff point, given the prevalence of 49.8%. The prevalence of subtypes of depression was: Mild 26.9%, moderate 20.4% and severe 2.5%. A statistically significant association was found between depression and some socio-demographic factors which include age (p = 0.001, X2 = 11.46), gender (p = 0.001, X2 = 20.58)), marital status (p = 0.001, X2 = 11.16), educational status (p = 0.001, X2 = 10.8) and chronic medical conditions (p = 0.001, X2 = 11.77). Depressed outpatient is more likely to be over 40 yrs, female, married, having low level of education and suffering from chronic medical condition(s). However, there was no significant association between depression and employment status, family history of mental illness and substance use in this study. Conclusion: This study found high prevalence of depression among general outpatients. It is associated with age, marital status educational level and chronic medical conditions. General practitioners should lookout for depression especially among patients with the associated socio-demographic factors. Some easy-to-use screening tools like PHQ-2 should be included in the routine assessment of outpatients in Family Medicine departments. Task-sharing strategy as enshrined in mental health gap (mhGAP) document should be implemented to improve detection of depression at primary care level.
Highlights
Depression occupies the 8th place among the causes of DALYs [1] in low income countries, due to preponderance of communicable, maternal, peri-natal and nutritional conditions
Depression among general outpatients has been studied by many researchers in Nigeria [4]-[6] and other parts of the world [7]
This study set out to determine the prevalence of depression and its associated factors among general outpatients in Kano, North-western Nigeria
Summary
Depression occupies the 8th place among the causes of DALYs [1] in low income countries, due to preponderance of (group I) communicable, maternal, peri-natal and nutritional conditions. Ihezue and Kumaraswamy of university of Nigeria Teaching Hospital, Enugu, used Zung’s self rating Depression scale among 132 first time attendees of general outpatient clinic reported 14% score within the range of mild depression while 11% obtained scores within the range of moderate depression [6] Another by study reported a much higher prevalence of 77% with mild, moderate and severe subtypes of depression of 62%, 14% and 1% respectively [10]. History of Mental Illness and Depression Ohaeri and Otote reported a study in Nigeria that family history of mental illness was associated with depression and significantly more common in psychotic or severe depression than in mild to moderate depression [23] Factors such as that concealment of positive family history of mental illness was to avoid the disadvantage it confers in marriage and relationships may be considered in interpreting this finding [24]. Aiyelero et al in ABUTH Zaria found very low history of substance use among depressed patient [32], though their finding could be attributed to the fact that the use of alcohol is prohibited in Islam which the predominant religion practice by majority of the people who reside in the area where the study was conducted
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