TITLE:
Impact of Somatic Symptoms on Identification of Depression among General Outpatients by Family Physicians in North-Western Nigeria
AUTHORS:
Auwal Sani Salihu
KEYWORDS:
Depression, General Outpatients, General Practitioners, Nigeria, Identification, Somatic Symptoms
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.5 No.3,
June
8,
2015
ABSTRACT: In many places in the
world, General Practitioners are only able to identify depression in a small
fraction of depressed patients presenting to general outpatient department. The
effect of somatic symptoms on its recognition was investigated. The study
determines the identification rate of depression by general practitioners among
outpatients with somatic symptoms and those without somatic symptoms. This
descriptive cross sectional study was conducted in Family Medicine Department,
Aminu Kano Teaching Hospital, Kano, Nigeria. The Hospital Anxiety and
Depression Scale (HADS) was used to screen selected participants. Forms were
used by GPs to itemize medical and psychiatric symptoms elicited as well as
medical and psychiatric diagnoses made. Schedule for Clinical Assessment in
Neuropsychiatry (SCAN) version 2.1, was used to confirm the diagnosis of
depression. Hamilton Depression Rating Scale (HDRS) was used for severity using
items 11-14 of Hamilton Depression Rating Scale. Those with somatic symptoms
score of 1-3 were rated as having low and those with 4-10 were rated as having
high. Of the 410 outpatients recruited, 402 participated in the study. Two hundred
and thirteen were screened depressed (HADS). Two hundred were confirmed
depressed using SCAN (49.8%). The GPs identified 31.3% of those participants
diagnosed depressed without somatic symptoms compared to 15.2% of those who
were diagnosed depressed with somatic symptoms. However, no significant
association was found between GPs ability to identify depression in the
presence or absence of somatic symptoms (p = 0.09). This study found no
association between GPs ability to identify depression and presence or absence
of somatic symptoms (χ2 =
2.75, p = 0.09). However, this study found that the higher the level of somatic
symptoms the more unlikely it’s for GPs to identify depression. To reduce the
burden of depression by early detection and treatment, continuing medical
education of GPs should include skills in identification of depression.