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

Author(s):  
Abiodun O Adewuya ◽  
Olabisi Oladipo ◽  
Tolu Ajomale ◽  
Tomilola Adewumi ◽  
Olufisayo Momodu ◽  
...  

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.

2004 ◽  
Vol 12 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Linda A. Travis ◽  
Jeffrey M. Lyness ◽  
Cleveland G. Shields ◽  
Deborah A. King ◽  
Christopher Cox

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A416-A417
Author(s):  
B Mason ◽  
A Tubbs ◽  
L Hale ◽  
C Branas ◽  
M Barrett ◽  
...  

Abstract Introduction Mobile technology use in bed is becoming commonplace and associated with habitual short sleep duration. The present study examined whether device use at night was related to mental health. Methods Data from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study comes from a community-based sample, which was restricted to N=473 between the ages of 22-29. Device use was assessed as presence in the room at night, any use at night, texting, emailing, browsing the internet, making or receiving calls, and using social media. Participants were also asked how often they are woken by a call/alert from their phone (unplanned), how often they are woken by their phone alarm (planned), and how often they check their phone at night. These were recorded as never, rarely, some nights, almost every night, and every night, and were assessed as an ordinal outcome. Predictors included score on the Patient Health Questionnaire depression scale (PHQ9), GAD7 anxiety scale, Perceived Stress Scale (PSS), and Multidimensional Scale of Perceived Social Support (MSPSS). Ordinal logistic regression analyses were adjusted for age, sex, race/ethnicity, education, and income. Results Depression was associated with texting (oOR=1.03, p=0.025), email (oOR=1.03, p=0.022), internet (oOR=1.05, p=0.003), unplanned awakenings (oOR=1.05, p=0.001), and checking the phone (oOR=1.09, p<0.0005). Anxiety was associated with texting (oOR=1.05, p=0.001), email (oOR=1.05, p=0.001), internet (oOR=1.05, p=0.002), social media (oOR=1.04, p=0.009), unplanned awakenings (oOR=1.06, p<0.0005), planned awakenings (oOR=1.04, p=0.025), and checking the phone (oOR=1.10, p<0.0005). Perceived stress was associated with internet (oOR=1.02, p=0.034), unplanned awakenings (oOR=1.02, p=0.045), and checking (oOR=1.04, p<0.0005). Social support was associated with decreased checking (oOR=0.98, p=0.018). Conclusion Mobile device use at night itself is not associated with mental health, but specific activities may be. Also, those who report more disruptions from the device and more checking of the device also report worse mental health. Relationships might be bidirectional. Support Dr. Grandner is supported by R01MD011600 The SHADES study was funded by R21ES022931


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Acuti Martellucci ◽  
V Montagna ◽  
G Acquaviva ◽  
A Masiero ◽  
L Biardi ◽  
...  

Abstract Background In Italy, in 2015 suicide rate was 6.5/100,000 inhabitants, while in 2017 depressive disorders were estimated to represent 2.3% of total DALYs. The indicator for monitoring mental health is the suicide rate, but surveys such as the European Health Interview Survey (EHIS) of 2015 have identified several predictors of depression. We aim to assess trends in factors associated to depression in Italy, from 2013 to 2017. Methods Data from the Aspects of Daily Living survey (AVQ) carried out by the Italian Statistics Institute, from years 2013 to 2017, were used in this analysis. Investigated factors were those identified as predictors of depression in Italy according to the EHIS 2015: (1) education until middle high school and (2) high school, (3) poor social support (single-person households without friends, neighbours, or relatives to count on), (4) unemployment, (5) chronic disease, (6) moderate limitations of daily activity due to poor health, and (7) severe limitations. We calculated the prevalence of these factors, and 95% Confidence Intervals (CI), by sex and year. Results The prevalence of poor social support rose, differing significantly in men between 1.5% (95% CI 1.3% - 1.8%) in 2013 and 2.1% (95% CI 1.9% - 2.3%) in 2017. Unemployment decreased in men, from 12.7% (95% CI 12.0% - 13.4%) to 10.4% (95% CI 10.0% - 10.8%), whereas chronic diseases and moderate limitations grew significantly in both sexes, at respectively 24.6% (95% CI 24.0% - 25.2%) and 16.1% (95% CI 15.6% - 16.6%) for men, and 29.0% (95% CI 28.4% - 29.6%) and 19.4% (95% CI 18.9% - 19.9%) for women in 2017. Conclusions The growing proportions, in Italy, of people with poor social support, chronic diseases, and moderate limitations of daily activities, suggest that health care programming at the national level should prepare for a rising burden of mental disease in these groups, and take into account measures to promote well-being. Key messages Among factors associated with depression, poor social support, chronic diseases, and moderate physical limitations due to disease showed a growing trend in Italy from 2013 to 2017. The Italian yearly AVQ survey investigates predictors of mental disease, particularly depression, and could provide early data for effective health care programming and mental health promotion.


2020 ◽  
Vol 14 (4) ◽  
pp. 155798832093721
Author(s):  
Daphne C. Watkins ◽  
Janelle R. Goodwill ◽  
Natasha C. Johnson ◽  
Allura Casanova ◽  
Tao Wei ◽  
...  

Conventional definitions of mental health, manhood, and social support create barriers to accessing behavioral health care for Black men ages 18 to 30. Targeted behavioral health interventions sensitive to culture, social norms, and gender that circumvent these barriers are desperately needed to improve access and integrated care for this group. This article reports mixed methods findings from the 2017 iteration of the Young Black Men, Masculinities, and Mental Health (YBMen) project, a social media–based, psychoeducational program that promotes mental health, progressive definitions of manhood, and sustainable social support for Black men. Young Black men ( n = 350) across two universities in the Midwest completed baseline surveys on their mental health, definitions of manhood, and social support. Forty of the men participated in the YBMen intervention and at postintervention reported experiencing fewer depressive symptoms on the Patient Health Questionnaire (PHQ-9, Z = −2.05, p < .01) and the Gotland Male Depression Scale (GMDS; Z = −1.76, p < .05). There were also changes on the Conformity to Masculine Norms Inventory (CMNI) for Self-Reliance ( Z = −0.34, p = .26) and Heterosexual Self-Presentation ( Z = −0.18, p = .59), though these changes were not statistically significant. A qualitative review of postintervention interviews revealed participants’ appreciation of the YBMen project and its influence on their mental health, manhood, and social support. Programmatic efforts that support the behavioral health, positive development, and social relationships of Black men translate into positive families, communities, and experiences as they live, learn, love, and work over the life course.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11543-11543
Author(s):  
Kelly Marie Trevino ◽  
Christian J. Nelson ◽  
Rebecca Saracino ◽  
Beatriz Korc-Grodzicki ◽  
Saman Sarraf ◽  
...  

11543 Background: Surgery is a notable stressor for older adults with cancer who are often medically complex and frail. The American College of Surgeons Commission on Cancer requires distress screening in accredited cancer care settings. The degree to which distress screening leads to mental health use is unclear. This study examined rates and predictors of post-surgical mental health care in older adults referred for a preoperative evaluation. Methods: Patients aged 75 years or older (n = 1,008) referred to the Geriatrics Service at a comprehensive cancer center were enrolled. Patients underwent elective surgery with a length of stay of 3 days or longer and were followed for at least 30 days after surgery. A comprehensive geriatric assessment (CGA) was administered as part of routine care. Surgical characteristics and post-surgical encounters with social work, psychology, and psychiatry were abstracted from the electronic medical record. Bivariate relationships between demographic and surgical characteristics and the CGA and post-operative receipt of mental health services were examined. Characteristics with significant (p < .01) bivariate relationships were entered into a multivariable regression predicting post-operative mental health service use. Results: One-quarter of the total sample (n = 246, 24.4%) received post-operative mental health services. In multivariable analyses, high distress (Distress Thermometer score≥4; p = .01), poor social support (p = .01), iADL dependence (p = .04), and longer length of stay (p < .001) were associated with receipt of mental health services after controlling for significant sociodemographic and surgical characteristics and CGA variables. Of patients with high distress, poor social support, or iADL dependence, only one-third (29-33%) received mental health care. Conclusions: Distressed older adults and those with low levels of support pre-operatively were more likely to receive mental health services after surgery, controlling for sociodemographic and surgical characteristics. Yet, only one-third of these patients received mental health care. These findings suggest that barriers to translating distress screening into provision of mental health services remain.


2021 ◽  
Author(s):  
Susan Smith ◽  
Emma Wallace ◽  
Barbara Clyne ◽  
Fiona Boland ◽  
Martin Fortin

Abstract BackgroundMultimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.MethodsWe searched eight databases and two trials registers up to 9th September 2019. Two review authors independently screened and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.ResultsWe included 16 RCTs with 4,753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI -0.01 to 0.07, I2 = 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall the certainty of the evidence was graded as low due to significant variation in study participants and interventions. Conclusions There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.


2016 ◽  
Vol 4 (3) ◽  
pp. 433
Author(s):  
Bo Kim ◽  
Stephanie Rodrigues ◽  
Natalie S Dell ◽  
Rani Elwy

Rationale, aims and objectives  After screening positive for depression, many patients do not receive effective medication or maintain optimal contact with practitioners.  Our objective was to examine how appointments that patients have after screening positive may affect the delivery of evidence-based and guideline-concordant depression care. Methods  We reviewed treatment records for 271 patients who screened positive for depression in primary care across three United States Veterans Health Administration medical facilities.  For each patient, we mapped the process of appointments that took place following the positive screen, noting the number of appointments, the service line in which each appointment was held, as well as whether guideline-concordant depression care was in turn received over four months. Results  We found that (i) approximately half of the patients who screened positive had no follow-up appointments, (ii) all patients who had two or more follow-up appointments received some – but not necessarily guideline-concordant – mental health treatment, and (iii) there were distinct patterns across the three facilities regarding which service lines’ appointments most often resulted in treatment. Conclusions  Our work offers a novel approach of using data on appointments that patients have after screening positive for depression to shed light on current care practices.  The number of post-screening appointments can be an informative process measure for improving depression care to become more guideline-concordant.  Facilities vary substantially in terms of which service lines they use to attain guideline-concordance, likely due to notable differences in how their primary care, integrated primary care behavioral health, and mental health services are organized.


2011 ◽  
Vol 33 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Sandra Fortes ◽  
Claudia S. Lopes ◽  
Luiz A. B. Villano ◽  
Mônica R. Campos ◽  
Daniel A. Gonçalves ◽  
...  

OBJECTIVE: Common mental disorders are present in more than 50% of patients attending primary care clinics. The main objectives of this study were to detect whether there is any special group of patients within the Family Health Strategy that should be considered to be in greater risk for common mental disorders and to recommend alternative interventions to aid these patients. METHOD: In 2002, a cross-sectional study on common mental disorders seen at Family Health Strategy centers was conducted in Petrópolis, State of Rio de Janeiro. RESULTS: Common mental disorders were associated with women (OR = 2.90; 95% CI 1.82-4.32), younger than 45 years of age (OR = 1.43; 95% CI 1.02-2.01), with a monthly per capita family income of less than US$40.00 (OR = 1.68; 95% CI 1.20-2.39), and without a partner (OR = 1.71; 95% CI 1.22-2.39). Illiteracy was associated with common mental disorders among patients who were not extremely poor. Social support networks such as going often to church (OR = 0.62; 95% CI 0.43-0.89); participating in artistic and sporting activities (OR = 0.42; 95% CI 0.26-0.70) and having at least four trusted relatives or friends (OR = 0.53; 95% CI 0.31-0.91) was inversely associated with common mental disorders. DISCUSSION: Poor women with little social support represent a special group at risk for common mental disorders in the primary care setting. Some countries have developed special interventions to treat patients with common mental disorders in primary care. CONCLUSION: Mental health care programs could include evidence-based psychosocial interventions to assist women in overcoming the vicious circle of poverty and dealing with their mental disorders.


1997 ◽  
Vol 27 (1) ◽  
pp. 33-45 ◽  
Author(s):  
George R. Parkerson ◽  
Robert A. Gutman

Objective: To compare perceived current mental health and disablement between primary care and end-stage renal disease (ESRD) patients, and to study social support and stress and severity of illness as possible determinants of mental health and disablement. Method: Observational cross-sectional analysis of 414 primary care patients in a rural community health center and 125 ESRD patients requiring hemodialysis in two community dialysis units. The Duke Health Profile (DUKE) anxiety-depression scale was used to assess mental health; the DUKE disability scale, to indicate disablement; the Duke Social Support and Stress Scale, to measure support and stress; and the Duke Severity of Illness Scale, to rate severity of illness. Results: Perceived current mental health in terms of anxiety and depression symptoms was worse for primary care than for ESRD patients, and perceived current disablement was no different for the two groups. Patients' perception of their health status and of stress from family members were more closely associated with their level of anxiety and depression symptoms than were their diagnostic profiles or overall severity of illness. In turn, their level of anxiety and depression symptoms was the principal correlate of their disablement. Conclusions: The demonstration of strong relationships among anxiety and depression symptoms, disablement, and family stress in these two very different patient populations should stimulate further research and motivate clinicians to evaluate all three parameters as part of routine patient care.


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