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Adewuya AO, Oladipo O, Ajomale T, Adewumi T, Momodu O, Olibamoyo O, Adesoji O, Adegbokun A, Adegbaju D. Epidemiology of depression in primary care: Findings from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. Int J Psychiatry Med 2022; 57:6-20. [PMID: 33573444 DOI: 10.1177/0091217421996089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olabisi Oladipo
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Tolu Ajomale
- Mental Health Desk Office, Lagos State Ministry of Health, Ikeja, Lagos
| | - Tomilola Adewumi
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olufisayo Momodu
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Olushola Olibamoyo
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olabanji Adesoji
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Adedayo Adegbokun
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Dapo Adegbaju
- Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
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Fadipe B, Oshodi YO, Umeh C, Aikomo K, Ajirotutu OF, Kajero J, Fashanu C, Adeoye AA, Coker AO, Sokunbi M, Nyamali VO, Ajomale T, Gbadebo A, Oni A, Keshinro AO, Ngozi Ejiegbu TA, Bowale A, Akase IE, Mutiu B, Adebayo B, Abdus-Salam I, Bode C, Osibogun A. Psychosocial health effects of Covid-19 infection on persons in treatment centers in Lagos, Nigeria. Brain Behav Immun Health 2021; 16:100284. [PMID: 34151305 PMCID: PMC8205258 DOI: 10.1016/j.bbih.2021.100284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Prior research has highlighted the psychosocial impact of infectious diseases on individuals and the community at large. However, little is known about the psychosocial implications of COVID-19. This study set out to determine the rate as well as correlates of anxiety and depressive symptoms among persons managed as in-patients for COVID-19 in Lagos, Nigeria. Materials and methods We conducted an online survey between April to June ending 2020 using a consecutive sampling technique of persons positive for COVID-19 and who were managed as in-patients across five (5) treatment centres in Lagos, Nigeria. The survey collected information on demographic as well as clinical data including suicidality. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Results There were one hundred and sixty participants in total. The mean age of respondents was 36.4 (±9.7) years with a higher proportion (56.9%) being males. With regards to diagnosis, 28.1% and 27.5% of the respondents were categorised as probable cases of depression and anxiety respectively, while 3.8% respondents reported suicidal ideation. Majority of the respondents (61.9%) reported the fear of infecting their loved ones. The variables that showed association with psychiatric morbidity were a past history of an emotional concern, employment status, guilt about infecting others and boredom. Conclusion This study revealed a high burden of psychological/psychiatric morbidity among persons treated for COVID-19, particularly persons who have had prior emotional concerns. The findings from this study reiterate the need to pay attention to the mental health of people during disease outbreaks and to incorporate psychosocial interventions as part of the management package.
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Affiliation(s)
- Babatunde Fadipe
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Yewande O Oshodi
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Charles Umeh
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Kehinde Aikomo
- Dept of Medical Social Work, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | | | | | | | | | - Ayodele Olurotimi Coker
- Department of Psychiatry, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria
| | | | | | - Tolu Ajomale
- Lagos State Ministry of Health, Ikeja, Lagos, Nigeria
| | | | - Adedapo Oni
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | | | | | | | - Iorhen E Akase
- Infectious Disease Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), Nigeria
| | - Bamidele Mutiu
- Lagos State Biobank, Mainland Hospital, Yaba, Lagos, Nigeria
| | - Bisola Adebayo
- Department of Community Health and Primary Care, Lagos State University, College of Medicine, Ikeja, Lagos, Nigeria
| | | | - Chris Bode
- Department of Surgery, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Akin Osibogun
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
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Adewuya AO, Ola BA, Coker O, Atilola O, Fasawe A, Ajomale T. A stepped care intervention for non-specialist health workers' management of depression in the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria: A cluster randomised controlled trial. Gen Hosp Psychiatry 2019; 60:76-82. [PMID: 31351240 DOI: 10.1016/j.genhosppsych.2019.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The study aimed to evaluate the clinical effectiveness of a developed stepped care intervention for management of depression in primary care. METHODS A cluster randomised controlled trial with primary care centres (PHCs) as unit of randomization. Five PHCs were randomised to stepped care intervention (SCI) group and another 5 PHCs were randomised to enhanced usual care (eUCA) control group. Participants were adults (18-60 years) with clinically significant depression symptoms. The primary outcome was clinical recovery at 12th months follow up. The outcome assessors were blinded to the cluster allocation. RESULTS There were 456 participants in SCI group and 451 in eUCA group. At 12 months, clinical recovery was significantly higher in the SCI group compared with the eUCA group (60.3% vs 18.2%, ARR 3.10, 95% CI 2.15-3.87). The SCI group also had significantly better quality of life and lesser rates of disability, death or deliberate self-harm compared to the eUCA group. Subgroup analysis within the SCI group showed no difference in clinical outcomes between participants receiving problem solving therapy (PST) and those receiving antidepressants. CONCLUSIONS Our study showed that stepped care intervention significantly improved clinical outcomes at 12 months. This lends support to growing evidence of clinically effective intervention for depression at primary care level in less resourced countries. TRIAL REGISTRATION http://www.isrctn.com/ISRCTN66243738.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Centre for Mental Health Research & Initiative (CEMHRI), Lagos, Nigeria; Lagos State Ministry of Health, Lagos, Nigeria.
| | - Bolanle A Ola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olurotimi Coker
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
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