The role of family bio-social variables in depression in a resource-constrained environment: A cross-sectional study of ambulatory adult patients in a primary care clinic in Eastern Nigerian

Abstract

Background: Depression is a family and public health condition that has negative consequences for the victim, family, friends, and society with significant socio-family dysfunction, especially when it is undiagnosed. Aim: The present study was aimed at determining the role of family bio-social variables in depression among ambulatory adult patients in a primary care clinic in the Eastern Nigerian. Materials and Methods: A clinic-based cross-sectional descriptive study was carried out on 400 adult patients in a primary care clinic in Nigeria. Data were collected using Patient Health Questionnaire-9, Family Assessment Device, Multidimensional Scale of Perceived Social Support and Brief Family Relationship Scale. Results: The age of the study participants ranged from 18 to 78 years. There were 40.5% of male and 59.5% of female. The prevalence of depression was 48.5% with the most common pattern being mild depression (32.3%). Depression was significantly associated with unhealthy family functioning (P = 0.002), low-acuity family support (P = 0.039), family with least cohesion (P = 0.044), least expressiveness (P = 0.013), and most conflict (P = 0.013). The most significant predictor of depression was unhealthy family functioning (Odds ratio = 3.14 [1.82–3.77]; P = 0.001). Depressed patients who had unhealthy family functioning were three times more likely to experience depressive illness compared to their counterparts who were from healthy functional family. Conclusion: Depression occurred among the study participants and was significantly associated with unhealthy family functioning, low family support, least family cohesion and expressiveness and most family conflict. Assessment of family biosocial factors should be part of the reason for encounter during consultation to unravel family variables that positively or negatively influence depression.

Keywords

• Adult Nigerians
• biosocial variables
• depression
• family
• primary care