Abstract
Background
Depression is more prevalent in medically ill patients than in the general population. More is not known about depression rates in internal medicine outpatients consulting the teaching hospitals in Rwanda. Adults with medical diseases are more likely to develop depression, it is an often-unrecognized co-morbidity in this group, and it has a major impact on their function and disability. In the absence of studies in our region, we did this research in our country with interest in what factors might be associated with depressive symptoms.
Methods
The descriptive cross-sectional study was used to determine the prevalence of depression and associated factors among internal medicine outpatients of Kigali university teaching hospital (CHUK). The 9 items Patient Health Questionnaire (PHQ-9) instrument was used to screen depression symptoms among outpatients. The validated cut-off score of 10 for diagnosing depression was applied in this study. Patients’ clinical and socio-demographic characteristics were collected and analyzed for their relationship with depression. All patients who scored PHQ-9 above 10 were referred to CHUK mental health department for appropriate management.
Results
Three hundred patients were recruited, of whom 65.3%) were females and 51% had an age between 45 and 96 years. The overall prevalence of depression among outpatients in the internal medicine department of CHUK was 45.7%. Outpatients had 20.7%, 17%, and 10% for moderate, moderately severe, and severe depression, respectively. Age, educational status, and follow-up visits as current physical complaints were independently associated with depression (P < 0.05). As much as 22.7% of patients were presenting with Suicidal ideas. The study showed that low income was strongly associated with suicide ideation (P < 0.001). Regardless of age and gender, the prevalence of depression was higher among outpatients of internal medicine than the general population.
Conclusions
A holistic approach in the management of internal medicine outpatients should be implemented to facilitate the early detection and treatment of depression in general tertiary hospitals. Furthermore, intervention programs that address depression and suicide in adults are needed.
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