Depression and disability: comparisons with common physical conditions in the Ibadan study of aging.
OBJECTIVE
To compare the effects of depression and chronic physical conditions on disability in elderly persons.


METHODS
Yoruba-speaking areas of Nigeria.


METHODS
Interviews. PATICIPANTS: Community-dwelling persons aged 65 and older.


METHODS
Face-to-face interviews were conducted with a representative sample of community-dwelling persons aged 65 and older (N=2,152) in the Yoruba-speaking areas of Nigeria (representing approximately 22% of the national population). Major depressive disorder (MDD) was assessed using the World Health Organization Composite International Diagnostic Interview. Chronic pain and medical disorders were assessed using self-report. Disorder-specific disability was evaluated using the Sheehan Disability Scale (SDS).


RESULTS
MDD was highly comorbid with each of the medical conditions (odds ratio range 1.3-2.0). A higher proportion of persons with MDD (47.2%) were rated severely disabled globally than those with arthritis (20.6%), chronic spinal pain (24.2%), or high blood pressure (25.0%). Subjects with MDD were also more likely to be severely disabled in three of the four domains of the SDS. In pair-wise comparisons, persons with MDD had significantly higher levels of disability than those with any of the disorders, with differences in mean scores ranging between -3.74 and -27.50.


CONCLUSIONS
To reduce the public health burden of depression, its prevention and treatment require more clinical and research attention than currently given by developing countries.
Gureje
Oye
O
Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria.
Ademola
Adedotun
A
Olley
Benjamin O
BO
D000368:Aged; D001168:Arthritis / Q000453:epidemiology* / Q000523:psychology; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence