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Luitel NP, Lamichhane B, Pokhrel P, Upadhyay R, Taylor Salisbury T, Akerke M, Gautam K, Jordans MJD, Thornicroft G, Kohrt BA. Prevalence of depression and associated symptoms among patients attending primary healthcare facilities: a cross-sectional study in Nepal. BMC Psychiatry 2024; 24:356. [PMID: 38745133 PMCID: PMC11092057 DOI: 10.1186/s12888-024-05794-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Depression is a prevalent mental health condition worldwide but there is limited data on its presentation and associated symptoms in primary care settings in low- and middle-income countries like Nepal. This study aims to assess the prevalence of depression, its hallmark and other associated symptoms that meet the Diagnostic and Statistical Manual (DSM-5) criteria in primary healthcare facilities in Nepal. The collected information will be used to determine the content of a mobile app-based clinical guidelines for better detection and management of depression in primary care. METHODS A total of 1,897 adult patients aged 18-91 (63.1% women) attending ten primary healthcare facilities in Jhapa, a district in eastern Nepal, were recruited for the study between August 2, 2021, and March 25, 2022. Trained research assistants conducted face-to-face interviews in private spaces before the consultation with healthcare providers. Depression symptoms, including hallmark symptoms, was assessed using the validated Nepali version of the Patient Health Questionnaire (PHQ-9). RESULTS One in seven (14.5%) individuals attending primary health care facilities in Jhapa met the threshold for depression based on a validated cut-off score ( > = 10) on the PHQ-9. The most commonly reported depressive symptoms were loss of energy and sleep difficulties. Approximately 25.4% of women and 18.9% of men endorsed at least one of the two hallmark symptoms on the PHQ-9. Using a DSM-5 algorithm (at least one hallmark symptom and five or more total symptoms) to score the PHQ-9, 6.3% of women and 4.3% of men met the criteria for depression. The intra-class correlation coefficient for PHQ-9 total scores by health facility as the unit of clustering was 0.01 (95% confidence interval, 0.00-0.04). CONCLUSION Depression symptoms are common among people attending primary healthcare facilities in Nepal. However, the most common symptoms are not the two hallmark criteria. Use of total scores on a screening tool such as the PHQ-9 risks overestimating the prevalence and generating false positive diagnoses. Compared to using cut off scores on screening tools, training health workers to first screen for hallmark criteria may increase the accuracy of identification and lead to better allocation of treatment resources.
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Affiliation(s)
- Nagendra P Luitel
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal.
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioural Health, George Washington University, Washington, D.C, USA.
| | - Bishnu Lamichhane
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
| | - Pooja Pokhrel
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
| | - Rudrayani Upadhyay
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Makhmud Akerke
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Kamal Gautam
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioural Health, George Washington University, Washington, D.C, USA
| | - Mark J D Jordans
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Brandon A Kohrt
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioural Health, George Washington University, Washington, D.C, USA
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Amaike C, Salami OF, Bamidele OT, Ojo AM, Otaigbe I, Abiodun O, Adesola O, Adebiyi AO. Association of depression and anxiety with uncontrolled hypertension: A cross-sectional study in Southwest Nigeria. Indian J Psychiatry 2024; 66:157-164. [PMID: 38523755 PMCID: PMC10956585 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_751_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Background Hypertension is a medical condition of public health concern that increases the risk of chronic noncommunicable diseases and mortalities. In recent years, understanding its coexistence with other comorbidities has been the focus of better management. However, the relationship between hypertension and depression or anxiety has been contentious issue, with diverse findings reported by different studies. Understanding this relationship will be crucial for blood pressure control and reducing the mortality associated with hypertension. Therefore, this study was conducted to determine the association between depression or anxiety and hypertension control. Methods A cross-sectional study was conducted among 321 hypertensive patients accessing care in two hospitals. Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). The relationship between blood pressure control and depression or anxiety was assessed using binary logistic regression. Results The prevalence of depression and anxiety was 12.1% and 23.1%, respectively. Up to 261 (81.3%) participants had uncontrolled blood pressure. Of these 261 participants, 14.2% and 23.4% had depression and anxiety, respectively. Depression was associated with an increased risk of uncontrolled blood pressure after adjusting for sex, smoking cigarettes, age, marital status, and exercise (odds ratio (OR) = 7.751, 95% confidence interval (CI) = 1.79-43.4, P = 0.011). Conclusion Depression appears to be independently associated with an increased risk of uncontrolled blood pressure. It is therefore relevant for healthcare providers to assess for depression in patients with hypertension to ensure better hypertensive control.
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Affiliation(s)
- Chikwendu Amaike
- Department of Community Medicine, Babcock University and Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Omotayo F. Salami
- Department of Surgery, Ben Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
- Department of Anesthesia, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Olabisi T. Bamidele
- Department of Chemical Pathology, Ben Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Abayomi M. Ojo
- Federal Neuropsychiatric Hospital, Yaba, Lagos State, Nigeria
| | - Idemudia Otaigbe
- Department of Medical Microbiology, School of Basic Clinical Sciences, Benjamin Carson (Snr) College of Health and Medical Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Olumide Abiodun
- Department of Community Medicine, Babcock University and Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | | | - Akindele O. Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
- Department of Centre for Research Innovation and Development, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
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Ogungbemi AO, Afolabi BA, Falade J, Ajayi AA, Ajayi AO, Adedire A, Falope IV, Olayemi O, Afolabi AA, Ogungbemi OA, Anjorin SS. Assessment of Depressive Symptoms and Sociodemographic Correlates of Adult Patients Attending a National Health Insurance Clinic at a Tertiary Hospital, Southwest Nigeria. Niger Med J 2024; 65:16-30. [PMID: 39006172 PMCID: PMC11238166 DOI: 10.60787/nmj-v65i1-448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background Depression affects individuals across all age groups, genders, and socio-economic backgrounds. Socio-demographic correlates of depression may include factors such as age, gender, education level, income, and marital status. These factors, including the presence of chronic diseases, have been shown to impact the prevalence and severity of depression. This study assessed the prevalence of depressive symptoms and its association with socio-demographic correlates and co-morbid chronic medical conditions among adult patients attending a National Health Insurance Clinic of a tertiary health facility in Southwest Nigeria. Methodology A hospital-based descriptive cross-sectional study was conducted between April - May 2023 in which 250 consenting adult patients were recruited using a systematic random sampling technique. Respondents' information on socio-demographic profiles and awareness of co-morbid medical conditions were assessed using semi-structured interviewer-administered questionnaires. Depressive symptoms were determined using the Patient Health Questionnaire. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using chi-square and the p-value was set as <0.05. Results The mean age of respondents was 38.96±13.096 years (range: 18-80 years). There were 159 (63.6%) females. The prevalence of depressive symptoms was 44.8%. There was a statistically significant association between age, gender, marital status, monthly income, presence of chronic diseases, and depressive symptoms. Conclusion The prevalence of depressive symptoms among adult patients attending the National health insurance clinic was 44.8%. These findings call for health policies to integrate and strengthen mental health in NHIA primary care.
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Affiliation(s)
| | | | - Joshua Falade
- Mental Health Unit, Dept of Internal Medicine, University of Medical Sciences, Ondo State
| | | | | | - Adejare Adedire
- Department of Surgery, Osun State University, Osogbo, Osun State
| | | | - Olanrewaju Olayemi
- Department of Internal Medicine, Osun State University, Osogbo, Osun State
| | | | | | - Seun Stephen Anjorin
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Adedeji WA, Ma Q, Raji AM, Cha R, Rasaki OM, Hutson A, Taiwo BO, Charurat ME, Yusuf OB, Fehintola FA, Gureje O, Morse GD. Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors. AIDS Res Ther 2023; 20:89. [PMID: 38104102 PMCID: PMC10725593 DOI: 10.1186/s12981-023-00586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023] Open
Abstract
Major depression is the most common neuropsychiatric disorder among people living with HIV (PLWH) and is predictive of high morbidity and mortality among them. This study estimated the prevalence and explored factors associated with depression among PLWH in two rural secondary health facilities providing anti-retroviral therapy (ART) services in Southwestern Nigeria between September and December 2020. The Patient Health Questionnaire-9 (PHQ-9) was used to screen and identify PLWH aged 18 years or older with depression. Descriptive statistics, bivariate and multivariate analyses were performed with SPSS version 23. A total of 172 respondents were screened. The prevalence of depression was 16.3% (95% CI 11.1%, 22.7%). Mild, moderate, and moderately severe depression was identified in 17 (9.9%), 8(4.7%) and 3(1.7%) of the participants, respectively. One (0.6%) respondent had suicidal ideation. Of PLWH with any depression, 20/28(71.4%) were within the 40-59 years of age range. None of the participants was on antidepressants. The factor most associated with depression was hypertension, with adjusted odd ratios of 9.8(95% CI 3.5-27.3, p < 0.0001). The study highlights the importance of screening for the severity of depression among PLWH in rural hospitals providing ART services in Africa. PLWH with comorbid hypertension were more likely to suffer from some form of depression.
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Affiliation(s)
- Waheed Adeola Adedeji
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria.
| | - Qing Ma
- Center for Integrated Global Biomedical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Abiodun Muhammed Raji
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - Raymond Cha
- Center for Integrated Global Biomedical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Alan Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Babafemi O Taiwo
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Man E Charurat
- Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Oyindamola B Yusuf
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Fatai Adewale Fehintola
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Gene D Morse
- Center for Integrated Global Biomedical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
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Imarhiagbe CO, Dickson CI, Owen TPI, Soroye MO, Okocha AN, Dienye PO. Sociodemographic Factors Associated with Depression Among Persons with Type 2 Diabetes Mellitus in The Family Medicine Clinic of a Tertiary Hospital in Southern Nigeria. Niger Med J 2023; 64:545-555. [PMID: 38952877 PMCID: PMC11214708 DOI: 10.60787/nmj-64-4-337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 07/03/2024] Open
Abstract
Background Diabetes Mellitus (DM) is a chronic Non-Communicable Disease (NCD) with rising prevalence worldwide. DM increases the risk for depression as the prevalence of depression has been reported to be three times more in diabetics than in non-diabetics. Though depressive symptoms are more common in diabetes, they are not usually recognized and treated. Little is known about the predictors of depression in this group of people, especially among the Nigerian population. This study explored the sociodemographic factors associated with depression in patients with type 2 DM without prior psychiatric history. Methodology This was a cross-sectional study conducted among two hundred and sixty-four patients using structured questionnaires. Data were analyzed using the Statistical Package for Social Sciences version 20. Chi-square tests were performed to compare associations between categorical variables. A probability (p) value less than 0.05 was taken as statistically significant. Results Females [176 (66%)] were three times more than males [88 (33.3%)] respectively. The prevalence of depression was 49.2%. Level of education (p= 0.008), occupation (p= 0.014), and social class (p= 0.040) were significantly associated with depression among the respondents. Depression was higher among the older age group, females, and the widowed. Conclusion Females and older adults were more affected by depression. The predictors of depression were level of education, occupation, and social class. Thus, there is a need to screen those who have been diagnosed with T2DM for depression, especially females and older adult patients.
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Affiliation(s)
| | - Christian Ibe Dickson
- Department of Family Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria
| | - Titi Precious-Ibiye Owen
- Department of Family Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria
| | | | - Ada Nkemagu Okocha
- Department of Family Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria
| | - Paul Owajionyi Dienye
- Department of Family Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria
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Adewuya AO, Oladipo O, Ajomale T, Adewumi T, Momodu O, Olibamoyo O, Adesoji O, Adegbokun A, Adegbaju D. Epidemiology of depression in primary care: Findings from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. Int J Psychiatry Med 2022; 57:6-20. [PMID: 33573444 DOI: 10.1177/0091217421996089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To estimate the rate and correlates of depression in primary care using data from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. METHODS Adult attendees (n=44,238) of 57 primary care facilities were evaluated for depression using the Patient Health Questionnaire (PHQ-9). Apart from the socio-demographic details, information was also collected regarding the use of alcohol and other psychoactive substances, presence of chronic medical problems, level of functionality, and perceived social support. Anthropometrics measures (weight and height) and blood pressure were also recorded. RESULTS A total of 27,212 (61.5%) of the participants were females. There were 32,037 (72.4%) participants in the age group 25-60 years. The rate of major depression (PHQ-9 score 10 and above) was 15.0% (95% CI 14.6-15.3). The variables independently associated with depression include age 18-24 years (OR 1.69), female sex (OR 2.39), poor social support (OR 1.14), having at least one metabolic syndrome component (OR 1.57), significant alcohol use (OR 1.13) and functional disability (OR 1.38). CONCLUSION Our study showed that the rate of depression in primary care in Nigeria is high. Screening for all primary care attendees for depression will be an important step towards scaling up mental health services in Nigeria and other developing countries.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olabisi Oladipo
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Tolu Ajomale
- Mental Health Desk Office, Lagos State Ministry of Health, Ikeja, Lagos
| | - Tomilola Adewumi
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olufisayo Momodu
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Olushola Olibamoyo
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olabanji Adesoji
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Adedayo Adegbokun
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Dapo Adegbaju
- Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
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Musa ZA, Soh KL, Mukhtar F, Soh KY, Oladele TO, Soh KG. Impact of Mindfulness-Based Cognitive Therapy on Depressive Symptoms Reduction among Depressed Patients in Nigeria: A Randomized Controlled Trial. Issues Ment Health Nurs 2021; 42:667-675. [PMID: 32996802 DOI: 10.1080/01612840.2020.1821139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression is a common mental health disease with a high risk of relapse in people with a mental health condition. Mindfulness-based cognitive therapy (MBCT) showed higher efficacy in reducing depressive symptoms and prevent relapse for depressed patients. The study examined the effectiveness of MBCT versus the control group (CG) for the depression symptom reduction. A controlled trial was used to examine the effectiveness of MBCT or CG on depressive patients in Nigeria. Out of 357 screened subjects, 101 patients were randomized to receive either MBCT (n = 50) or CG (n = 51) and prospectively followed for 2 months. The intervention delivered according to the published manuals, and Beck Depression Inventory (BDI) was used to assess MDD severity among the patients. All assessments were conducted at three levels (baseline, 2 and 4 months). At the end of the 8 weeks of MBCT intervention, MBCT participants did not have significantly fewer depressive symptoms compared to those in the CG. However, the MBCT group had a significant depressive symptom reduction after 2 month follow up. The findings are in line with other studies, which show MBCT significantly decreased depression severity and improved treatment response rates after 2 months follow up, confirmed MBCT viability in the management of MDD.
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Affiliation(s)
- Zulkiflu Argungu Musa
- Faculty of Health and Allied Sciences, Department of Nursing Sciences, Usman Danfodiyo University, Sokoto, Nigeria.,Faculty of Medicine and Health Sciences, Department of Nursing and Rehabilitation, Universiti Putra Malaysia, Serdang, Serlangor State, Malaysia
| | - Kim Lam Soh
- Faculty of Medicine and Health Sciences, Department of Nursing and Rehabilitation, Universiti Putra Malaysia, Serdang, Serlangor State, Malaysia
| | - Firdaus Mukhtar
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Universiti Putra Malaysia, Serdang, Selangor State, Malaysia
| | - Kwong Yan Soh
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Universiti Putra Malaysia, Serdang, Selangor State, Malaysia
| | | | - Kim Geok Soh
- Faculty of Educational Studies, Department of Sport Studies, Universiti Putra Malaysia, Serdang, Selangor State, Malaysia
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Obadeji A, Kumolalo BF, Ajiboye AS, Oluwole LO, Oderinde KO, Ebeyi RC. Substance use among commercial motorcyclists and its relationship with life satisfaction and significant depressive symptoms. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2020.1800844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Adetunji Obadeji
- Psychiatry, Ekiti State University, Ekiti State University College of Medicine, Ado Ekiti, Nigeria
| | - Banji F. Kumolalo
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | | | - Lateef Olutoyin Oluwole
- Psychiatry, Ekiti State University, Ekiti State University College of Medicine, Ado Ekiti, Nigeria
| | | | - Rose Chidindu Ebeyi
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
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Edetanlen E, Ogbikaya A, Azodo C. Screening for depression among dental patients in Benin city sub population of Nigeria. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjos.sjoralsci_32_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nwefoh E, Aguocha CM, Ryan G, Ode P, Ighagbon FO, Akinjola O, Omoi S, Abdulmalik J, Agbir TM, Obekpa O, Ogbole S, Eaton J. Depression and experience of incarceration in North Central Nigeria: a situation analysis at Makurdi medium security prison. Int J Ment Health Syst 2020; 14:76. [PMID: 33133236 PMCID: PMC7592553 DOI: 10.1186/s13033-020-00408-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/15/2020] [Indexed: 01/03/2023] Open
Abstract
Background Human rights watchdogs have described conditions in Nigerian correctional facilities and detention centers as damaging to the physical and mental health of inmates. While the prevalence of mental disorders is high, access to appropriate healthcare is grossly inadequate. Understanding the current state of prison inmates’ mental health and well-being is an essential first step to addressing this important issue. This study aims to document the mental health and experiences of incarceration of inmates of the largest medium security prison in Nigeria’s Benue State. Methods A cross-sectional survey and descriptive analysis was carried out with a random sample of 381 prison inmates of Benue State Makurdi Medium Security Prison. Survey tools included: (1) a structured questionnaire on participants’ experiences in prison, and (2) the Patient Health Questionnaire (PHQ-9), a screening tool for depression. Results Most participants were young men (95.5%, mean age 27.95) and had completed secondary school (63.5%). While prison authorities had identified only 27 participants as having a mental disorder, 144 (37.8%) screened positive for depression. Twenty six had received professional counseling while in prison. Of the six participants who were already taking a psychotropic medication at the time of imprisonment, four received medication after being imprisoned. Approximately half, (52%) of participants were dissatisfied with prison health care. Conclusions Despite the high prevalence of depression among prison inmates, few cases are detected and treated. Prison staff may not recognize depression as a mental disorder, and the mental health care available is generally poor. Inadequate mental health and social care not only affects prison inmates’ well-being, but may also impact recidivism and health outcomes upon release. Prison inmates should be screened routinely for depression and other less-commonly recognized mental health conditions, and appropriate treatment made available.
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Affiliation(s)
- Emeka Nwefoh
- CBM Country Co-Ordination Office, Abuja, Nigeria
| | | | - Grace Ryan
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Philip Ode
- CBM Country Co-Ordination Office, Abuja, Nigeria
| | | | | | - Samuel Omoi
- CBM Country Co-Ordination Office, Abuja, Nigeria
| | | | | | | | - Samuel Ogbole
- Benue State Comprehensive Community Mental Health Programme, Otukpo, Nigeria
| | - Julian Eaton
- CBM Global and Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
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Obadeji A, Kumolalo B, Bamidele J, Olasehinde T. Road traffic accidents among commercial motorcyclists: Relationship with substance use and psychosocial factors. SOCIAL HEALTH AND BEHAVIOR 2020. [DOI: 10.4103/shb.shb_9_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adewuya AO, Ola BA, Coker O, Atilola O, Fasawe A, Ajomale T. A stepped care intervention for non-specialist health workers' management of depression in the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria: A cluster randomised controlled trial. Gen Hosp Psychiatry 2019; 60:76-82. [PMID: 31351240 DOI: 10.1016/j.genhosppsych.2019.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The study aimed to evaluate the clinical effectiveness of a developed stepped care intervention for management of depression in primary care. METHODS A cluster randomised controlled trial with primary care centres (PHCs) as unit of randomization. Five PHCs were randomised to stepped care intervention (SCI) group and another 5 PHCs were randomised to enhanced usual care (eUCA) control group. Participants were adults (18-60 years) with clinically significant depression symptoms. The primary outcome was clinical recovery at 12th months follow up. The outcome assessors were blinded to the cluster allocation. RESULTS There were 456 participants in SCI group and 451 in eUCA group. At 12 months, clinical recovery was significantly higher in the SCI group compared with the eUCA group (60.3% vs 18.2%, ARR 3.10, 95% CI 2.15-3.87). The SCI group also had significantly better quality of life and lesser rates of disability, death or deliberate self-harm compared to the eUCA group. Subgroup analysis within the SCI group showed no difference in clinical outcomes between participants receiving problem solving therapy (PST) and those receiving antidepressants. CONCLUSIONS Our study showed that stepped care intervention significantly improved clinical outcomes at 12 months. This lends support to growing evidence of clinically effective intervention for depression at primary care level in less resourced countries. TRIAL REGISTRATION http://www.isrctn.com/ISRCTN66243738.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Centre for Mental Health Research & Initiative (CEMHRI), Lagos, Nigeria; Lagos State Ministry of Health, Lagos, Nigeria.
| | - Bolanle A Ola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olurotimi Coker
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
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The effectiveness and acceptability of mobile telephone adherence support for management of depression in the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria: A pilot cluster randomised controlled trial. J Affect Disord 2019; 253:118-125. [PMID: 31035212 DOI: 10.1016/j.jad.2019.04.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/03/2019] [Accepted: 04/07/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND To evaluate the effectiveness and acceptability of adding a mobile telephone adherence support to a Collaborative Stepped Care (CSC) intervention for primary care management of depression. METHODS A pilot cluster randomised controlled trial with 10 primary care centres in Lagos Nigeria, randomised into either the mobile telephone supported CSC (mCSC) group or the ordinary CSC (oCSC) group in ratio 1:1. The 5 mCSC clusters received in addition to the CSC intervention, a series of tailored informational text messages and reminders. Participants were adults (18-60 years) with depression. The primary outcome was the rate of adherence to intervention at 6th and 12th months follow up. Analysis was by intention to treat. RESULTS The mCSC group (n = 439 participants) had significantly better adherence rate compared to oCSC group (n = 456 participants) at 6th month (90.0% vs 67.8%, ARR 1.31, 95% CI 1.22-1.40) and at 12th month follow up (78.1% vs 59.2%, ARR 1.30, 95% CI 1.20-1.43). Compared to the oCSC group, the mCSC had significantly higher recovery rate, better quality of life, retention in treatment, was more cost effective and had high level of acceptance amongst clients LIMITATION: Self rating scales were not used for adherence score. We analysed according to Intention to Treat and we have not included mild depression CONCLUSION: The addition of our mobile telephony support significantly improves adherence and clinical outcomes for CSC intervention and was cost effective and acceptable to clients. Mobile telephone technology can substantially aid the scale up of mental health services in developing countries.
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Screening for Depressive Symptoms among Patients Attending Specialist Medical Outpatient Clinics in a Tertiary Hospital in Southern Nigeria. PSYCHIATRY JOURNAL 2018; 2018:7603580. [PMID: 30498751 PMCID: PMC6220747 DOI: 10.1155/2018/7603580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 09/27/2018] [Indexed: 11/17/2022]
Abstract
This study aimed to determine the prevalence of unrecognized depressive symptoms and its associated risk factors among patients with diabetes and/or hypertension attending medical outpatient clinics of a tertiary health centre in southern Nigeria. A cross-sectional study design was employed to assess 200 randomly selected patients attending the clinics. Questionnaires were administered to obtain sociodemographic and medical history data. The perceived stress scale (PSS) was used to determine the presence of subjective psychological stress and PHQ-9 was used to screen for depression. The prevalence of depressive symptoms was 54.9% with 16.5% categorised as having major depression. After adjusting for confounding variables, age younger than 60 years was associated with less odds of having depressive symptoms (AOR 0.32, 95% CI 0.17, 0.62; p=0.001), while only significant psychological stress increased the odds of having depressive symptoms (AOR 2.78, 95% CI 1.37, 5.64; p=0.005). The prevalence of depression among the study participants is high and has the potential to significantly impact the control of their disease and ultimately contribute to the high cardiovascular risk faced by this population.
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Luitel NP, Baron EC, Kohrt BA, Komproe IH, Jordans MJD. Prevalence and correlates of depression and alcohol use disorder among adults attending primary health care services in Nepal: a cross sectional study. BMC Health Serv Res 2018; 18:215. [PMID: 29587724 PMCID: PMC5869789 DOI: 10.1186/s12913-018-3034-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/19/2018] [Indexed: 11/07/2022] Open
Abstract
Background Although depression and alcohol use disorder (AUD) are expected to be common among patients presenting to primary health care setting, there is limited research on prevalence of depression and AUD among people attending primary health care services in low-income countries. The aim of this study was to assess the prevalence of depression and AUD among adults attending primary care facilities in Nepal and explore factors associated with depression and AUD. Methods We conducted a population-based cross-sectional health facility survey with 1474 adults attending 10 primary healthcare facilities in Chitwan district, Nepal. The prevalence of depression and AUD was assessed with validated Nepali versions of the Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT). Results 16.8% of the study sample (females 19.6% and males 11.3%) met the threshold for depression and 7.3% (males 19.8% and females 1.1%) for AUD. The rates of depression was higher among females (RR = 1.48, P = 0.009), whereas rates of AUD was lower among females (RR = 0.49, P = 0.000). Rates of depression and AUD varied based on education, caste/ethnicity, occupations and family income. Conclusions In Nepal, one out of five women attending primary care services have depression and one out of five men have AUD. Primary care settings, therefore, are an important setting for detection and treatment initiation for these conditions. Given that “other” occupation is at increased risk for both conditions, it will be important to assure that treatments are feasible and effective for this high risk group.
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Affiliation(s)
- Nagendra P Luitel
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal.
| | - Emily C Baron
- Alan J. Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - Brandon A Kohrt
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal.,Department of Psychiatry, George Washington University, Washington, DC, USA
| | - Ivan H Komproe
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands.,Research and Development Department, HealthNet TPO, Amsterdam, Netherlands
| | - Mark J D Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Majekodunmi OE, Obadeji A, Oluwole LO, Oyelami O. Depression and associated physical co-morbidities in elderly prison inmates. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2017. [DOI: 10.1080/00207411.2017.1345040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Adetunji Obadeji
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Lateef Olutoyin Oluwole
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Olawoye Oyelami
- Ogun State Community Mental Health Services Oke-Ilewo, Abeokuta, Ogun State, Nigeria
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17
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Bansal P, Chaudhary A, Soni RK, Sharma S, Gupta VK, Kaushal P. Depression and anxiety among middle-aged women: A community-based study. J Family Med Prim Care 2016; 4:576-81. [PMID: 26985419 PMCID: PMC4776612 DOI: 10.4103/2249-4863.174297] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Anxiety and depressive disorders constitute a substantial proportion of the global burden of disease and are projected to form the second most common cause of disability by 2020. Objective: To assess the level of depression and anxiety among middle age women and the possible factors behind it. Materials and Methods: A total of 180 women aged 40–60 years were selected by proportionate sampling technique. Age, education, marital status, socioeconomic status, age at marriage, age at menopause, weight and height were noted. Zung-self-rating scales were used for calculating levels of depression and anxiety in these women. The data were analyzed by using statistical software SPSS. Results: The level of syndromal depression and anxiety was found to be 86.7% and 88.9%, respectively. Most of the subjects had the moderate type of depression (49.5%) followed by mild (29.4%) and severe depression (7.8%). While in case of anxiety, most of the subjects (69.4%) had a mild form of anxiety and 17.8% had moderate anxiety level. A significant difference was observed in the level of depression with respect to marital status (P = 0.009) and in the level of anxiety with respect to age (P = 0.021) in the study subjects. On applying logistic regression, none of the factors studied were found to be significant variables for anxiety or depression in the study population. Conclusion: Depression and anxiety are prevalent among the middle-aged women in rural Punjab. Provision of mental health services in this group is essential.
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Affiliation(s)
- Priya Bansal
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Anurag Chaudhary
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - R K Soni
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sarit Sharma
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikram Kumar Gupta
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Pushapindra Kaushal
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Tilahune AB, Bekele G, Mekonnen N, Tamiru E. Prevalence of unrecognized depression and associated factors among patients attending medical outpatient department in Adare Hospital, Hawassa, Ethiopia. Neuropsychiatr Dis Treat 2016; 12:2723-2729. [PMID: 27822044 PMCID: PMC5087759 DOI: 10.2147/ndt.s118384] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Depression is an illness that involves the body, mood, and thoughts and that affects the way a person eats, sleeps, feels about him or herself and thinks about things. Depression is one of the most common mental disorders affecting 121 million people in the world, and it frequently goes unrecognized among patients. It is estimated that 5%-10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention. An institution-based cross-sectional study design was implemented to determine the magnitude and associated factors of unrecognized depression among patients attending the adult medical outpatient department in Adare Hospital, Hawassa, Southern Nations, Nationalities, and Peoples' Region, Ethiopia, among 326 patients selected using systematic random sampling technique. Data were collected using the interviewer-administered technique. A structured questionnaire was used to collect data on sociodemographic characteristics and other independent variables. Depression was assessed using the Patient Health Questionnaire 9. Data were entered and ana-lyzed using SPSS 20. The level of significance was determined at P<0.05. About 326 patients were interviewed, of whom 186 (57.1%) were males. The mean age of participant was 34 with standard deviation of ±13.1 years. Current substance users accounted for 106 (32.5%) of the total participants. Of 326 respondents, 80 (24.5%) had significant depressive symptoms, while the detection rate of depression by the clinician was 0%. Depression was associated with female sex (adjusted odds ratio [AOR] =1.63 [1.14-2.34]), age >60 years (AOR =4.14 [1.87-9.14]), being divorced (AOR =3.13 [1.70-5.76]), and having an average monthly income <750 ETB (AOR =1.92 [1.119-3.195]). The findings of this study revealed that the prevalence of depression among patients attending general medical outpatient department was highly underrecognized and unmanaged. On the basis of these results, we recommended that health-care providers perform a thorough assessment to address common mental disorders, especially depression, and suggest that training to recognize and manage depression appropriately be given.
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Affiliation(s)
- Asres Bedaso Tilahune
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Gezahegn Bekele
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Nibretie Mekonnen
- Department of Medical Case Team, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - Eyerusalem Tamiru
- Department of Medical Case Team, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia
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