Improving Detection of Depression at Primary Health Care Settings in Ogun State, Nigeria
Improving Detection of Depression at Primary Health Care Settings in Ogun State, Nigeria
A. O. Olujobi,T. A. Joseph,6 Authors,Yetunde Olubodun
TLDR
Strategies aimed at enhancing the recognition and management of depression, such as mental health training focused on depressive disorders and the routine screening of patients using these tools, should be incorporated into the routine service package at the primary health care level, as these measures are likely to improve the detection of depression.
Abstract
One of the commonest mental health conditions managed in primary health care (PHC) is depression, with nearly 10% of all primary care consultations being related to depressive disorders. However, the detection of depression by PHC workers in developing countries remains markedly low. Routine screening for depression at the PHC level has the potential to improve the detection of depression. This study was undertaken to enhance the detection of depression through systematic screening in PHC settings in Ogun State, Nigeria.
Methodology
This study was conducted in 20 primary health care (PHC) centres across two randomly selected senatorial districts (Ogun West and Ogun Central) in Ogun State, Nigeria. The Patient Health Questionnaire-2 (PHQ-2) and the depression module of the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) were used to screen for depression among consenting patients who met the inclusion criteria in the designated PHC centres. A PHQ-9 score of ≥10 was used to confirm the diagnosis of depression. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics were summarised using frequencies, means, standard deviations, and percentages, while comparisons of quantitative variables were performed using the independent samples t-test. Statistical significance was set at p < 0.05.
Results
Out of the 493 patients screened for depression, 26.8% met the criteria for a diagnosis of depression. The mean depression score in Ogun West, where screening was conducted using the PHQ-2 and mhGAP-IG, was significantly higher (19.8) than that observed in Ogun Central (14.5) (p = 0.001). Most of the identified cases were of mild severity (50.8%). Females constituted the majority (62.3%) of the participants diagnosed with depression.
Conclusion
This study has demonstrated the synergistic screening effect of the PHQ-2 and mhGAP-IG manual in improving the detection of depression in primary health care settings in Ogun State, Nigeria. Strategies aimed at enhancing the recognition and management of depression, such as mental health training focused on depressive disorders and the routine screening of patients using these tools,should be incorporated into the routine service package at the primary health care level, as these measures are likely to improve the detection of depression.