Abstract
Depression is a common disorder characterized by delayed help-seeking, often remaining undetected and untreated. We sought to estimate the proportion of adults in Kamuli District with depressive symptoms and to assess their help-seeking behaviour. This was a population-based cross-sectional study conducted in a rural district in Uganda. Sampling of study participants was done using the probability proportional to size method. Screening for depression was done using Patient Health Questionnaire (PHQ-9). The participants who screened positive also reported on whether and where they had sought treatment. Data collected using PHQ-9 was used both as a symptom-based description of depression and algorithm diagnosis of major depression. All data analysis was done using STATA version 13. With a cut-off score of ⩾10, 6.4% screened positive for current depressive symptoms and 23.6% reported experiencing depressive symptoms in the past 12 months. The majority of individuals who screened positive for current depression (75.6%) were females. In a crude analysis, people with lower education, middle age and low socio-economic status were more likely to have depressive symptoms. Help-seeking was low, with only 18.9% of the individuals who screened positive for current depression having sought treatment from a health worker. Depressive symptoms are common in the study district with low levels of help-seeking practices. People with lower levels of education, low socio-economic status and those in middle age are more likely to be affected by these symptoms. Most persons with current depression had past history of depressive symptoms.
Highlights
Depression is a common disorder characterized by delayed help-seeking, often remaining undetected and untreated
Several studies in African countries have documented the prevalence of depressive disorder ranging from 1.8% to as high as 42.4% among people with other physical conditions such as HIV/AIDS, heart disease and diabetes (Adewuya et al 2006; Mbakwem & Aina, 2008; Agbir et al 2010)
The outcome data reported were collected in a cross-sectional population-based survey of adults aged 18 years and above, using a standardized screening tool for depressive symptoms, the Patient Health Questionnaire-9th version (PHQ-9) (Kroenke et al 2001)
Summary
Depression is a common disorder characterized by delayed help-seeking, often remaining undetected and untreated. A growing body of evidence suggests that mental health problems are a major contributor to the burden of disease globally. Mental disorders are estimated to contribute about 14% to the global disease burden; with depression, in particular, contributing 3.8% of the Disability Adjusted Life Years globally (Prince et al 2007; Brhlikova et al 2011; Ferrari et al 2013). The 2010 global burden of disease study identified depressive disorders as the second leading cause of disability globally; emphasizing the importance of including depressive disorders as a public health priority and implementing interventions to reduce its burden (Ferrari et al 2010). A total of 70 participants with both current and past depressive symptoms were further assessed for suicide ideation. 233 persons with only past depressive symptoms were asked for suicidal ideation, and 11 of them (4.7%) reported having had suicidal thoughts. Six of the 11 (54.5%) had made suicidal plans, and four of them had attempted suicide.
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