Depression and the nature of Trinidadian family practice: a cross-sectional study.

ABSTRACT

BACKGROUND: Depression is the most common mental disorder; in an ambulatory-care setting 5 to 10 per cent of patients meet the criteria for major depression. Despite extensive documentation in primary care internationally, Trinidadian studies published on depression have been primarily hospital-based and focussed on suicide. The objectives of this study were to determine the prevalence of depression, the variables associated with depression and the commonest reason for the encounter (RFE) among adult patients attending Trinidadian fee-for-service family practice? METHODS: This was a cross-sectional descriptive survey of consecutive patients taken from a stratified random sample of family practices in the north-west region of Trinidad. To measure depression the Zung scale was modified for use as a brief diagnostic tool. This modified Zung scale, when tested against a psychiatric interview, revealed that at a cut off point of 60, the scale had a specificity of 94 per cent (95 per cent CI 87-100), a sensitivity of 60 per cent (95 per cent CI 45-75), and a likelihood ratio for a positive test result of 10 (95 per cent CI 6-42). RESULTS: 508 patients from 28 practices participated; a response rate of 85 per cent. Participants were primarily younger 18-49 years (66.7 per cent), female (69.5 per cent), and educated, with 72.8 per cent having received a secondary school, technical school or university education. Sixty-five (12.8 per cent) of the respondents (95 per cent CI 9.9-15.7) were determined to be depressed. Chi-square analysis revealed no statistically significant association between depression and age, ethnicity, education levels, occupation or marital status (p > 0.05).