Depression screening in primary care patients

Abstract

Introduction

Depression is a common mental disorder that can be associated with more functional disability than most chronic medical illnesses and the increased reporting of medically unexplained somatic symptoms.

Aim

To assess the prevalence of depression in a Tunisian population, as well as the associated factors.

Methods

We conducted a cross-sectional, descriptive and analytic study, among 707 subjects consulting in 20 primary care units in Sfax and Tunis, Tunisia. These participants, randomly chosen, were asked to answer a questionnaire after their consent. Depressive symptoms were evaluated using the “Beck Depression Inventory” (BDI).

Results

The mean age of participants was 39.84 years. Among them, 38.6% had a low educational level (illiterate or primary school level); 45.3% were professionally inactive and 92.9% had a low to medium socio economic level. Medical, psychiatric and suicide attempt histories were reported respectively in 51.2%, 7.6% and 1.8% of cases. According to BDI, a mild depression was noted in 22.9%; moderate 16.1%; severe 4.1%. Among those presenting a moderate to severe depression (MSD), only 16.8% were followed up in psychiatry, 4.2% were receiving antidepressant and 9.8% benzodiazepine. MSD was associated with low educational level (P < 0.001); low to medium socio economic level (P < 0.001); psychiatric histories (P < 0.001); suicide attempt histories (P < 0.001); somatic histories (P < 0.001).

Conclusion

Our study highlighted a high prevalence of depression that is still under diagnosed and therefore poorly managed. General practitioners should be made aware of the importance of screening for depression in medical patients because it not only complicates their overall medical treatments, but also impedes their physical and social functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.