Assessment of depression in a primary care setting in Nigeria using the PHQ-9

CONTEXT: Mental disorders are major contributors to the burden of diseases all over the world. In general practice, which provides essentially primary care, depression is the most common mental disorder seen and often goes unrecognized. AIMS: The aims of the study were to determine the prevalence of depression, the variables associated with depression, and the degree of recognition by the Physician in family medicine unit. SETTING AND DESIGN: A cross-sectional descriptive survey of consecutive patients who presented at the general medical out-patient unit of the State University Teaching Hospital, Ado-Ekiti, Nigeria was done. MATERIALS AND METHODS: Data were collected using a questionnaire incorporating sociodemographic variables and primary diagnosis made by attending Physician. Depression was assessed with the PHQ-9. RESULTS: Two hundred and seventy two patients were interviewed during the period of the study. Participants were mostly of 45 years or older (51.2%), female (59.9%), married (68.4%), and educated (85.7%). One hundred and thirty (47.8%) of the respondents had significant depressive symptoms with majority (49.2%) being classified as mild. Statistical analysis revealed significant association between depression and age, gender, marital status, and clinical diagnoses (P < 0.05). Over a quarter (28.7%) were presented with infectious diseases, other diagnoses made included cardiovascular disorders (15.8%), endocrine disorders (8.8%), psychiatric disorders other than depression (2.9%) and none had depression as primary diagnosis. CONCLUSIONS: The prevalence of depression among patients attending the general medical out-patient clinics is high and highly under-recognised.