Epidemiology of depression in primary care: Findings from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria.

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.