Depression among ambulatory adult patients in a primary care clinic in southeastern Nigeria

Abstract

Background: Depression is a global health problem that occupies eminent position in clinical and community mental health. As the global prevalence of depression increases, the sociomedical challenges associated with it increase, especially in resource-constrained environment. Aim: The study was aimed at describing depression among ambulatory adult patients in a primary care clinic in Southeastern Nigeria. Patients and Methods: A cross-sectional descriptive hospital-based study was carried out on 400 adult patients in a primary care clinic of Federal Medical Centre, Umuahia. Data on relevant epidemiological variables were collected using pre-tested, structured interviewer-administered questionnaire. Patient Health Questionnaire-9 was used to assess for depression. Data were analysed using the Statistical Package for the Social Sciences software version 21. Test of associations was done using Chi-test and logistic regression, and P < 0.05 was considered statistically significant. Results: The age of the study participants ranged from 18 to 78 years with mean age of 38 ± 9.2 years, and there were 40.5% males. The prevalence of depression was 48.5% with the most common type being mild depression (32.3%). Occurrences of symptoms were most frequent and severe in the home environment (59.8%) and during the night (62.9%). Hypertension (35.5%) and alcohol use (57.5%) were the most common medical condition and substance used, respectively. Depression was significantly associated with elderly age (P = 0.005), females (P = 0.017), physical inactivity (P = 0.039) and psychosocial stressors (P = 0.042). The most significant predictor of depression was elderly age (adjusted odds ratio = 2.50; 95% confidence interval [1.40–3.78]; P = 0.001). Older persons were three and half times more likely to have depression when compared to their counterparts who were younger. Conclusion: This study has demonstrated high prevalence of depression and some epidemiological factors in the occurrence of depression among the study participants. Depression occurred predominantly among the elderly, females, physically inactive, hypertensive and those who had psychosocial stressors. Occurrences of symptoms were most frequent at home and nighttime. The most commonly used substance was alcohol.

Keywords

• adult patients depression
• nigeria
• prevalence
• primary care