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


METHODS
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.


CONCLUSIONS
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.
Muhwezi
Wilson Winstons
WW
Dept. of Psychiatry, Faculty of Medicine, Makerere University, P.O. Box 7072, Kampala, Uganda. wmuhwezi@med.mak.ac.ug
Agren
Hans
H
Musisi
Seggane
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D016017:Odds Ratio; D010865:Pilot Projects; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology