Assessment of Depressive Symptoms and Sociodemographic Correlates of Adult Patients Attending a National Health Insurance Clinic at a Tertiary Hospital, Southwest Nigeria.
Main Article Content
Keywords
National Health Insurance, Co-Morbid Medical Conditions, Socio-Demographic Correlates, Depressive Symptoms
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.
References
2. Ormel J, Kessler RC, Schoevers R. Depression: More treatment but no drop in prevalence: how effective is treatment? And can we do better? Current opinion in psychiatry. 2019 Jul 1;32(4):348-54.
3. Gold SM, Köhler-Forsberg O, Moss-Morris R, Mehnert A, Miranda JJ, Bullinger M, Steptoe A, Whooley MA, Otte C. Comorbid depression in medical diseases. Nature Reviews Disease Primers. 2020 Aug 20;6(1):69.
4. Bailey RK, Mokonogho J, Kumar A. Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment. 2019 Feb 22:603-9.
5. World Health Organization. Depressive disorder (depression) [Internet]. World Health Organisation. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/depression. [Accessed Jan, 2024]
6. Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian population—The Chennai Urban Rural Epidemiology Study (CURES–70). PloS one. 2009 Sep 28;4(9): e7185.
7. Gureje O, Uwakwe R, Oladeji B, Makanjuola VO, Esan O. Depression in adult Nigerians: Results from the Nigerian survey of mental health and well-being. J Affect Disord 2010; 120:158-64.
8. Olanrewaju A, Akintunde A, Femi F, Ibrahim B, Olugbenga A. Pattern of depression and family support in a Nigerian family practice population. Internet J Fam Pract 2007; 6:1.
9. Shittu RO, Odeigah LO, Issa BA, Olarirewaju GT, Mahmoud AO, Sanni MA. Association between depression and social demographic factors in a Nigerian family practice setting. Open J Depress 2014; 3:18-23.
10. Obadeji A, Oluwole LO, Dada MU, Ajiboye AS, Kumolalo BF, Solomon OA, et al. Assessment of depression in a primary care setting in Nigeria using the PHQ-9. J Family Med Prim Care 2015; 4:30-4.
11. Okeafor CU, Chukwujekwu DC. Assessment of family functionality status among patients with mental illness at a tertiary health facility in Rivers State, Nigeria. N Niger J Clin Res 2017; 6:1-5
12. Fekadu, A., Demissie, M., Birhane, R. Under detection of depression in primary care settings in low and middle-income countries: a systematic review and meta-analysis. Syst Rev. 2022; 11, 21.
13. Islam, M. and Adnan, R. Socio-Demographic Factors and Their Correlation with the Severity of Major Depressive Disorder: A Population Based Study. World Journal of Neuroscience. 2017; 7, 193-202
14. Bonful HA, Anum A. Sociodemographic correlates of depressive symptoms: a cross-sectional analytic study among healthy urban Ghanaian women. BMC Public Health. 2019 Jan 10;19(1):50.
15. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013; 35:121-6
16. Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Ann 2002; 32:1-7.
17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 2001; 16:606-13.
18. Adewuya AO, Ola BA, Afolabi OO. Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord. 2006; 96:89–93.
19. Iloh GU, Aguocha GU, Amadi AN, Chukwuonye ME. Depression among ambulatory adult patients in a primary care clinic in Southeastern Nigeria. Nigerian Postgrad Med J 2018; 25:204-12
20. Mashaba BL, Moodley SV, Ledibane NRT. Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa. S Afr Fam Pract (2004). 2021 Jan 27;63(1):e1-e7.
21. Sanni OF, Onuoha FM, Alabi AN, Ayinmode BA, Buhari OA. Epidemiology of Depression in a Primary Care Setting in North Central Nigeria. Glob J Endocrinol Metab. 2018;2(4).
22. Health insurance coverage in Nigeria in 2018, by type and gender. Available from: https://www.statista.com/statistics/1124773/health-insurance-coverage-in-nigeria-by-type-and-gender/. [Accessed 27 April 2023]
23. National Population Commission, ICF. 2018 Nigeria Demographic and Health Survey. October 2019, 2022. Available from: https://www.dhsprogram.com/pubs/ pdf/FR359/FR359.pdf [Accessed April 2023]
24. Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci. 2021 Dec 10;11(12):1633.
25. Onyemaechi CI, Okere E, Chukwuemeka N, Ifeoma N. Practicum Psychologia.2017 ; 7 (1), 56-65. Available from: http://journals.aphriapub.com/index.php.pp ISSN: 2006-6640. [Accessed 1st May 2023]
26. WHO, (2017). Depression and Other Common Mental Disorders, Global Health Estimates. Available from: https://apps.who.int/iris/handle/10665/254610. [Accessed June 2023]
27. Singh A, Misra N. Loneliness, depression, and sociability in old age. Ind Psychiatry J. 2009 Jan;18(1):51-5.
28. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Med. 2013;10: e1001547
29. Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015 Jul;40(4):219-21.
30. Afolabi MO, Abioye-Kuteyi EA, Fatoye FO, Bello IS, Adewuya AO. Pattern of depression among patients in a Nigeria family practice population. South African Family Practice. 2008; 50, 63-69.
31. Pincus L, editor. Marriage: Studies in emotional conflict and growth. Taylor & Francis; 2023 Jul 5. 36.
32. Story LB, Bradbury TN. Understanding marriage and stress: Essential questions and challenges. Clinical psychology review. 2004 Jan 1;23(8):1139-62.
33. Bulloch AG, Williams JV, Lavorato DH, Patten SB. The relationship between major depression and marital disruption is bidirectional. Depression and anxiety. 2009 Dec;26(12):1172-7.
34. Lopizzo N, Bocchio Chiavetto L, Cattane N, Plazzotta G, Tarazi FI, Pariante CM, Riva MA, Cattaneo A.Gene–environment interaction in major depression: focus on experience-dependent biological systems. Frontiers in psychiatry. 2015 May 8; 6:68.
35. Brown, A. C., Brody, G. H., & Stoneman, Z. (2000). Rural black women and depression: A contextual analysis. Journal of Marriage and Family, 62, 187-198.
36. Akhtar-Danesh N, Landeen J. Relation between depression and socio-demographic factors. Int J Ment Health Syst. 2007; 1(1): 4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18271976
37. Zare H, Meyerson NS, Nwankwo CA, Thorpe Jr RJ. How income and Income Inequality Drive depressive symptoms in US Adults, does Sex Matter: 2005–2016. International journal of environmental research and public health. 2022 May 20;19(10):6227.
38. Adewuya AO, Oladipo O, Ajomale T, Adewumi T, Momodu O, Olibamoyo O, et al.. Epidemiology of depression in primary care: Findings from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. Int J Psychiatry Med. 2022 Jan;57(1):6-20.
39. Asmare Y, Ali A, Belachew A. Magnitude, and associated factors of depression among people with hypertension in Addis Ababa, Ethiopia: a hospital-based cross-sectional study. BMC.
40. Herrera PA, Campos-Romero S, Szabo W, Martínez P, Guajardo V, Rojas G. Understanding the relationship between depression and chronic diseases such as diabetes and hypertension: a grounded theory study. International journal of environmental research and public health. 2021 Nov 19;18(22):12130.
41. Sheng J, Liu S, Wang Y, Cui R, Zhang X. The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural plasticity [Internet]. 2017;2017(9724371):9724371. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28706741. [Accessed January 2024]
42. Mills SE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. British journal of anaesthesia. 2019 1;123(2): e273-83.
43. National Institute of Mental Health. Chronic Illness and Mental Health: Recognizing and Treating Depression [Internet]. National Institute of Mental Health. 2021. Available from: https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health. [Accessed June 2023]
44. Abiodun O, Sodeinde K, Imhonopi G, Omotosho A, Amaike C. Social isolation is associated with major depressive disorders among women accessing HIV/AIDS care in Nigeria. AIDS care. 2022 Jun 3;34(6):741-5.
45. Guan N, Guariglia A, Moore P, Xu F, Al-Janabi H. Financial stress, and depression in adults: A systematic review. PloS one. 2022Feb 22;17(2): e0264041.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.