Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa.

Journal: South African family practice : official journal of the South African Academy of Family Practice/Primary Care

Volume: 63

Issue: 1

Year of Publication: 2021

Affiliated Institutions:  School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, Gauteng Department of Health, Pretoria. bahupileng_lucy@yahoo.com.

Abstract summary 

Depression is a serious public health issue that has clinical, social and economic implications. Adult patients attending a primary healthcare (PHC) facility were screened in order to estimate the prevalence of depressive features and identify potential risk factors for screening positive.This was an analytical cross-sectional study conducted at a clinic in Pretoria, South Africa. A self-administered questionnaire, which included the Patient Health Questionnaire-9 (PHQ-9) screening tool, was completed by patients attending the clinic. A PHQ-9 score of less than five was deemed as a negative screen for depressive features; with a score of five or more being considered a positive screen. A multivariate logistic regression model was developed to identify factors associated with a positive screen for depressive features.A total of 199 patients participated and the proportion screened positive for depressive features using the PHQ-9 tool was 46.23% (n = 92). Employed participants had significantly lower odds (odds ratio [OR] = 0.48; 95% confidence interval [CI]: 0.25 - 0.94) of screening positive, whilst the participants with significantly higher odds were those with co-morbidities (OR = 2.12; 95% CI: 1.08 - 4.17) and a history of stressful life events (OR = 3.21; 95% CI: 1.64 - 6.28).Depression appears to be a significant problem in PHC settings in South Africa. Screening for depressive features at primary level, targeting those with chronic medical conditions, history of recent stressful life events and other known risk factors may improve detection rates, lead to earlier diagnosis and improved health outcomes.

Authors & Co-authors:  Mashaba Bahupileng L BL Moodley Saiendhra V SV Ledibane Neo R T NRT

Study Outcome 

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Statistics
Citations :  Marais D, Petersen I. Health system governance to support integrated mental health care in South Africa: Challenges and opportunities. Int J Ment Health Syst. 2015;9:1–21. 10.1186/s13033-015-0004-z
Authors :  3
Identifiers
Doi : 5217
SSN : 2078-6204
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
PHQ-9;depression;mental health;primary care;primary healthcare;screening
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
South Africa