title: Utilization of health care services by depressed patients attending the general out-patients department of the Jos University Teaching Hospital, Jos, Nigeria.
abstract: BACKGROUND
  Depression is a common psychiatric disorder in primary health care throughout the world with increasing incidence and prevalence. It is often under-treated and under-diagnosed. Consequently, several studies have revealed that patients with depression are high utilizers of medical services.
  
  
  OBJECTIVE
  The study was aimed at determining the frequency of consultation and the utilization of investigative procedures by the depressed and non-depressed patients in the last 12 months.
  
  
  METHODS
  This was a cross-sectional descriptive study among 200 consecutive patients attending the General Out-Patient Department of the Jos University Teaching Hospital between November 2006 and March 2007. A semi-structured questionnaire was used to collect socio-demographic data and health services utilization indices. Structured Clinical Interview for DSM-IV axis-1 Disorders (SCID) was used for diagnosis of depression.
  
  
  RESULTS
  The study found that 51(25.5%) of the respondents met DSM-IV criteria for the diagnosis of major depression while 149 (74.5%) did not. Depressed patients significantly had more number of consultations with their doctors (P=0.000), had consulted more number of hospitals (P=0.000), stayed longer on admission (P=0.000) and had consumed more types of medicine (P=0.005) in the last 12 months compared with the non-depressed. The depressed patients also had significantly higher mean of different types of investigations compared with non-depressed; urinalysis (1.69 vs 0.55, P=0.000), chest X-ray (0.57 vs 0.21, P=0.000) and Widal test (1.92 vs 0.39, P=0.000). Others are HIV screening (0.39vs0.11, P=0.000) urine mcs (0.94 vs 0.18, P=0.000), stool mcs (1.24 vs 0.20, P=0.000).
  
  
  CONCLUSIONS
  The study demonstrated that patients who suffer from depression are higher utilizers of health care resources compared with the non-depressed. Therefore, it is recommended that general practitioners and other health workers need to be better equipped to deal with the diagnosis and management of depression.
authors.affiliation: Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria. goarsuwa@yahoo.com
authors.forename: S G
authors.initials: SG
authors.lastname: Goar
authors.forename: A
authors.initials: A
authors.lastname: Obembe
authors.forename: M D
authors.initials: MD
authors.lastname: Audu
authors.forename: M T
authors.initials: MT
authors.lastname: Agbir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult