Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa

Background: Depression is a serious public health issue that has clinical, social and economic implications. Adult patients attending a primary healthcare (PHC) facility were screened in order to estimate the prevalence of depressive features and identify potential risk factors for screening positiv...

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Main Authors: Bahupileng L. Mashaba, Saiendhra V. Moodley, Neo R.T. Ledibane
Format: Article
Language:English
Published: AOSIS 2021-01-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/5217
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author Bahupileng L. Mashaba
Saiendhra V. Moodley
Neo R.T. Ledibane
author_facet Bahupileng L. Mashaba
Saiendhra V. Moodley
Neo R.T. Ledibane
author_sort Bahupileng L. Mashaba
collection DOAJ
description Background: Depression is a serious public health issue that has clinical, social and economic implications. Adult patients attending a primary healthcare (PHC) facility were screened in order to estimate the prevalence of depressive features and identify potential risk factors for screening positive. Methods: This was an analytical cross-sectional study conducted at a clinic in Pretoria, South Africa. A self-administered questionnaire, which included the Patient Health Questionnaire-9 (PHQ-9) screening tool, was completed by patients attending the clinic. A PHQ-9 score of less than five was deemed as a negative screen for depressive features; with a score of five or more being considered a positive screen. A multivariate logistic regression model was developed to identify factors associated with a positive screen for depressive features. Results: A total of 199 patients participated and the proportion screened positive for depressive features using the PHQ-9 tool was 46.23% (n = 92). Employed participants had significantly lower odds (odds ratio [OR] = 0.48; 95% confidence interval [CI]: 0.25 – 0.94) of screening positive, whilst the participants with significantly higher odds were those with co-morbidities (OR = 2.12; 95% CI: 1.08 – 4.17) and a history of stressful life events (OR = 3.21; 95% CI: 1.64 – 6.28). Conclusion: Depression appears to be a significant problem in PHC settings in South Africa. Screening for depressive features at primary level, targeting those with chronic medical conditions, history of recent stressful life events and other known risk factors may improve detection rates, lead to earlier diagnosis and improved health outcomes.
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spelling doaj-art-ef17806141024e07afb087e18ff8539d2025-08-20T03:47:09ZengAOSISSouth African Family Practice2078-61902078-62042021-01-01631e1e710.4102/safp.v63i1.52174112Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South AfricaBahupileng L. Mashaba0Saiendhra V. Moodley1Neo R.T. Ledibane2School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, Gauteng Department of Health, PretoriaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, PretoriaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, PretoriaBackground: Depression is a serious public health issue that has clinical, social and economic implications. Adult patients attending a primary healthcare (PHC) facility were screened in order to estimate the prevalence of depressive features and identify potential risk factors for screening positive. Methods: This was an analytical cross-sectional study conducted at a clinic in Pretoria, South Africa. A self-administered questionnaire, which included the Patient Health Questionnaire-9 (PHQ-9) screening tool, was completed by patients attending the clinic. A PHQ-9 score of less than five was deemed as a negative screen for depressive features; with a score of five or more being considered a positive screen. A multivariate logistic regression model was developed to identify factors associated with a positive screen for depressive features. Results: A total of 199 patients participated and the proportion screened positive for depressive features using the PHQ-9 tool was 46.23% (n = 92). Employed participants had significantly lower odds (odds ratio [OR] = 0.48; 95% confidence interval [CI]: 0.25 – 0.94) of screening positive, whilst the participants with significantly higher odds were those with co-morbidities (OR = 2.12; 95% CI: 1.08 – 4.17) and a history of stressful life events (OR = 3.21; 95% CI: 1.64 – 6.28). Conclusion: Depression appears to be a significant problem in PHC settings in South Africa. Screening for depressive features at primary level, targeting those with chronic medical conditions, history of recent stressful life events and other known risk factors may improve detection rates, lead to earlier diagnosis and improved health outcomes.https://safpj.co.za/index.php/safpj/article/view/5217depressionscreeningmental healthphq-9primary careprimary healthcare
spellingShingle Bahupileng L. Mashaba
Saiendhra V. Moodley
Neo R.T. Ledibane
Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
South African Family Practice
depression
screening
mental health
phq-9
primary care
primary healthcare
title Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
title_full Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
title_fullStr Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
title_full_unstemmed Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
title_short Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa
title_sort screening for depression at the primary care level evidence for policy decision making from a facility in pretoria south africa
topic depression
screening
mental health
phq-9
primary care
primary healthcare
url https://safpj.co.za/index.php/safpj/article/view/5217
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