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Detection of major depression in Ugandan primary health care settings using simple questions from a subjective well-being (SWB) subscale

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Abstract

Objective

To explore whether the 4-item subjective well-being subscale could be used to detect a major depressive illness. Secondly, to describe the prevalence and characteristics of depressed health care attendees at primary healthcare centres.

Method

Using a descriptive, cross-sectional study design, we interviewed 199 consecutive patients about their socio-demographics, subjective well-being (SWB), major depressive illness symptoms and depression severity. The instruments used were translated into Luganda.

Results

Point prevalence of a current Major Depressive Episode (MDE) was 31.6%. Using a one week reference period, we found that experiencing a lot of distress, having less energy or poor health, having poor emotional and psychological adjustment and not being satisfied with life were significantly more common among patients with a current MDE. The 4-item SWB subscale detected depression of up to 87.1% (95% CI: 0.818–0.923). In logistic regression, all four SWB items predicted a current MDE.

Conclusion

Major depressive illness is a common at primary healthcare level in Uganda. Four simple questions reflecting SWB items have potential to detect diagnosable patients likely to have a current MDE, making general screening procedures less necessary.

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Acknowledgements

This work is part of the project titled ‘‘Profiles of Depressive Illness in the Lake Victoria Basin (Uganda)’’, a collaboration between the Department of Psychiatry at Makerere University and the Department of Clinical Neuroscience, Section of Psychiatry at Karolinska Insitutet. We thank Sida/SAREC for funding the project. We also wish to thank interviewers and all study participants for having made this research possible. In a special way, we appreciate the effort of Dr. Stella Neema of Makerere Institute of Social Research (MISR) in the planning of the research study that produced this article.

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Authors and Affiliations

  1. Dept. of Psychiatry, Faculty of Medicine, Makerere University, P.O. Box 7072, Kampala, Uganda

    Wilson Winstons Muhwezi BA (SWSA), MPhil & Seggane Musisi MD, FRCP(C)

  2. Karolinska Institutet, Dept. of Clinical Neuroscience, Section of Psychiatry, Karolinska University Hospital Huddinge, Stockholm, Sweden

    Hans Ågren MD, PhD

Authors
  1. Wilson Winstons Muhwezi BA (SWSA), MPhil
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  2. Hans Ågren MD, PhD
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  3. Seggane Musisi MD, FRCP(C)
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Corresponding author

Correspondence to Wilson Winstons Muhwezi BA (SWSA), MPhil.

Additional information

W.W. Muhwezi is a Lecturer and Social Worker, Dept. of Psychiatry and also a Ph.D. student at Makerere University and Karolinska Institute, Dept. of Clinical Neuroscience, Psychiatry-HS, Stockholm, Sweden

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Muhwezi, W.W., Ågren, H. & Musisi, S. Detection of major depression in Ugandan primary health care settings using simple questions from a subjective well-being (SWB) subscale. Soc Psychiat Epidemiol 42, 61–69 (2007). https://doi.org/10.1007/s00127-006-0132-5

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  • DOI: https://doi.org/10.1007/s00127-006-0132-5

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