School of Health Sciences (Health-Sciences) Collections

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Browsing School of Health Sciences (Health-Sciences) Collections by Author "Ågren, Hans"
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    Detection of major depression in Ugandan primary health care settings using simple questions from a subjective well-being (SWB) subscale
    (Springer Verlag, 2007) Muhwezi, Wilson Winstons ; Ågren, Hans ; Musisi, Seggane
    Objective To explore whether the 4- item subjective well-being subscale could be used to detect a major depressive illness. Secondly, to describe the prevalence and characteristics of depressed health care attendees at primary healthcare centres. Method Using a descriptive, cross-sectional study design, we interviewed 199 consecutive patients about their socio-demographics, subjective well-being (SWB), major depressive illness symptoms and depression severity. The instruments used were translated into Luganda. Results Point prevalence of a current Major Depressive Episode (MDE) was 31.6%. Using a one week reference period, we found that experiencing a lot of distress, having less energy or poor health, having poor emotional and psychological adjustment and not being satisfied with life were significantly more common among patients with a current MDE. The 4-item SWB subscale detected depression of up to 87.1% (95% CI: 0.818–0.923). In logistic regression, all four SWB items predicted a current MDE. Conclusion Major depressive illness is a common at primary healthcare level in Uganda. Four simple questions reflecting SWB items have potential to detect diagnosable patients likely to have a current MDE, making general screening procedures less necessary.
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    Life events and depression in the context of the changing African family: the case of Uganda
    ( 2007) Muhwezi, Wilson Winstons ; Ågren, Hans ; Neema, Stella ; Musisi, Seggane ; Maganda, Albert Koma
    Introduction: Traditionally, the African extended family gave psychosocial support to all members, which cushioned any illness effects including depression. Recent changes in the African family, notably urbanization and market economies, have changed that structure. Changes, especially roles of the family and its relationship to life events and depression, have not received much research attention. Aim: To compare depressed and non-depressed patients in terms of their demographics, family structure, life events and depression. Methods: We compared quantitative data from 85 DSM-IV depressed patients that sought care at three Primary Health Care (PHC) centres with 170 unmatched non-depressed patients. To each group, we administered three questionnaires covering socio-demographics, family structure and an adapted Interview For Recent Life Events (IRLE). Results: Of the depressed patients, over 70% were females giving a M:F ratio of 2.3:1; 71.8% were aged < 39 years and 50.6% were married; the single were 14.1% and 73.9% belonged to maleheaded households. Depressed patients significantly differed from the non-depressed in having less postprimary education (p=0.02), fewer singles (0.04), fewer had regular incomes (p=0.01), more were single parents (p=0.02) and separated (p=0.01). Family structure in the two groups never significantly differed. For life events, depressed patients had more deaths of close family members and poor harvests (p=0.003), deaths of children and funeral rites (p=0.014) and sexual health problems (p=0.002). Positive exciting events were more common among non-depressed patients from extended families (p=0.047) while saddening and bereavement events were more common among depressed patients from extended families. Sexual problems were more common among depressed patients and from nuclear families (p= 0.001 & 0.006 respectively). Being a regular income earner was protective against depression [OR=0.45 (95% CI: 0.23-0.85)]. Conclusion: Depressed patients were often single, separated and had children signifying family break ups. They had less income, lower education and had experienced more negative life events, highlighting the weakened family ties in times of modern adversities. This calls for training of more mental health workers and informal helpers for vigorous family therapy interventions in modern Africa, in the face of the weakening extended family.
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    Life events associated with major depression in Ugandan Primary Healthcare (PHC) patients: issues of cultural specificity
    (SAGE Publications, 2008) Muhwezi, Wilson Winstons ; Ågren, Hans ; Neema, Stella ; Maganda, Albert Koma ; Seggane, Musisi
    Objective: The study compared life events experienced by depressed patients seen at primary healthcare (PHC) centres with those among healthy community controls. Method: 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. Conclusion: 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.