Undiagnosed depression among adults with diabetes mellitus in Jos.

BACKGROUND: Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care. METHOD: This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated. RESULTS: One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression. CONCLUSION: The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences.

Utilization of health care services by depressed patients attending the general out-patients department of the Jos University Teaching Hospital, Jos, Nigeria.

BACKGROUND: Depression is a common psychiatric disorder in primary health care throughout the world with increasing incidence and prevalence. It is often under-treated and under-diagnosed. Consequently, several studies have revealed that patients with depression are high utilizers of medical services. OBJECTIVES: The study was aimed at determining the frequency of consultation and the utilization of investigative procedures by the depressed and non-depressed patients in the last 12 months. MATERIALS AND METHODS: This was a cross-sectional descriptive study among 200 consecutive patients attending the General Out-Patient Department of the Jos University Teaching Hospital between November 2006 and March 2007. A semi-structured questionnaire was used to collect socio-demographic data and health services utilization indices. Structured Clinical Interview for DSM-IV axis-1 Disorders (SCID) was used for diagnosis of depression. RESULTS: The study found that 51(25.5%) of the respondents met DSM-IV criteria for the diagnosis of major depression while 149 (74.5%) did not. Depressed patients significantly had more number of consultations with their doctors (P=0.000), had consulted more number of hospitals (P=0.000), stayed longer on admission (P=0.000) and had consumed more types of medicine (P=0.005) in the last 12 months compared with the non-depressed. The depressed patients also had significantly higher mean of different types of investigations compared with non-depressed; urinalysis (1.69 vs 0.55, P=0.000), chest X-ray (0.57 vs 0.21, P=0.000) and Widal test (1.92 vs 0.39, P=0.000). Others are HIV screening (0.39vs0.11, P=0.000) urine mcs (0.94 vs 0.18, P=0.000), stool mcs (1.24 vs 0.20, P=0.000). CONCLUSION: The study demonstrated that patients who suffer from depression are higher utilizers of health care resources compared with the non-depressed. Therefore, it is recommended that general practitioners and other health workers need to be better equipped to deal with the diagnosis and management of depression.

Depression among medical outpatients with diabetes: a cross-sectional study at Jos University Teaching Hospital, Jos, Nigeria.

BACKGROUND: Clinical depression is a common problem among patients who seek medical care, and diabetic patients with comorbid depression tend to have higher health care cost. A dearth of literature exists on depression among diabetics in Nigeria. The objectives of the study were to determine the prevalence of depression among diabetic patients and to determine the sociodemographic correlates of depression among diabetics. METHODS: A cross-sectional descriptive study was conducted between December 2005 and April 2006 among patients who attend the diabetes clinic of Jos University Teaching Hospital (JUTH) with a laboratory and clinical evidence of diabetes mellitus. A semi-structured questionnaire was used to record the sociodemographic data of each consecutive patient followed by an interview by psychiatrists using the depression module of the Structured Clinical Interview for DSM-I V axis I disorder (SCID). Subsequently, the Hamilton Rating Scale for Depression (HDRS) was used to determine the severity of symptoms among subjects diagnosed with depression according to DSM-I V criteria. RESULTS: Thirty-one of the 160 subjects fulfilled the DSM-IV criteria for the diagnosis of a major depressive episode giving a 1-year prevalence rate of 19.4%. Depression was significantly correlated with sex (P=0.001) with a female-to-male ratio of 3:1 and was also significantly associated with unmarried diabetics (P=0.002) and those who had a poor relationship with their partners (P=0.04). No significant association was found between depression and the respondents' age (P=0.216), educational qualifications (P=0.268), employment status (P=0.84), place of residence (P=0.80), household composition (P=0.77), and monthly income (P=0.110). CONCLUSION: Depression is a common psychiatric disorder among diabetic subjects in this environment. It was suggested that diabetic patients be screened for depression to allow for early detection and treatment.

Gender and psychiatric diagnosis: a 5-year retrospective study in a Nigerian Federal Medical Centre.

BACKGROUND: The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore, aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic, psychiatry diagnosis and length of stay on admission. METHOD: In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi, between January, 2004 and December, 2008 were studied for gender differences regarding demographic attributes, length of stay and psychiatry diagnoses. RESULTS: Findings revealed that more men than women were admitted overall. Most men (56%) were less than 30 years old whereas 60.6% of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5%), followed by substance related disorders (16.5%) then depression (14.0%); for women the main diagnosis was also schizophrenia (30.3%), this was followed by depression (24.5%), only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p = 0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p = 0.161). CONCLUSION: The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation, it is imperative to pay attention to gender issues that may affect the development of psychopathology.

Gender and psychiatric diagnosis: a 5-year retrospective study in a Nigerian federal medical centre

The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore; aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic; psychiatry diagnosis and length of stay on admission. Method: In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi; between January; 2004 and December; 2008 were studied for gender differences regarding demographic attributes; length of stay and psychiatry diagnoses. Results: Findings revealed that more men than women were admitted overall. Most men (56) were less than 30 years old whereas 60.6of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5); followed by substance related disorders (16.5) then depression (14.0); for women the main diagnosis was also schizophrenia (30.3); this was followed by depression (24.5); only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p=0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p=0.161). Conclusion: The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation; it is imperative to pay attention to gender issues that may affect the development of psychopathology