Life events associated with major depression in Ugandan primary healthcare (PHC) patients: issues of cultural specificity.
OBJECTIVE
The study compared life events experienced by depressed patients seen at primary healthcare (PHC) centres with those among healthy community controls.


METHODS
Data was collected from 74 depressed patients and 64 unmatched controls from village locales of patients. Interview instruments included the depression module of the Mini International Neuropsychiatric Interview (MINI) and Interview for Recent Life Events (IRLE). Associations between type of respondent and demographic variables were examined. Statistical comparisons were done for the two groups on other variables.


RESULTS
Most depressed patients were single by marital status, lacked formal employment and had less post-primary education.They had experienced more life events; job changes, discomforting working hours, unfavourable working conditions, and job losses; personal health problems; loss of valuables; difficulties with intimate partners and family members' marital problems. Independent life events were more among depressed patients and clustered around work, health, bereavement and marriage. Most events reported by depressed patients had high negative impact ratings compared to controls.


CONCLUSIONS
Compared to healthy community controls, depressed patients reported more undesirable life events. The relationship between life events and depression implies that in PHC settings of poor countries, deploying mental health-oriented workers to manage life events may lessen escalation of distress.
Muhwezi
Wilson Winstons
WW
Department of Psychiatry, Faculty of Medicine, Makerere University, Kampala, Uganda. wmuhwezi@med.mak.ac.ug
Agren
Hans
H
Neema
Stella
S
Maganda
Albert Koma
AK
Musisi
Seggane
S
D000293:Adolescent; D000328:Adult; D001601:Bereavement; D016022:Case-Control Studies; D003156:Community Mental Health Services / Q000379:methods / Q000600:supply & distribution; D035061:Control Groups; D003466:Cultural Characteristics; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008393:Marriage; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D014454:Uganda / Q000453:epidemiology; D014937:Work