Describing the incidence of depressive symptoms and associated person's variables among emerging adults within a selected general hospital outpatient department in Kenya.

Abstract

Introduction: Suicide is a global health concern, specifically among the youth. Bio-psychosocial factors, specifically depression, are associated with suicide behaviour and viewed as potential risk indicators. Depression is under detected in health care settings and argued to add to the increasing incidence of suicide behaviour. Aim: To describe the incidence of physiological symptoms, and other person’s variables, and their association with depressive symptoms within the emerging adult, 18-24 age group, attending a general health care outpatient facility in Kenya. Method: A quantitative design utilized an interview assisted physiological symptom checklist, and a self-reported questionnaire obtained demographic data and participant responses to Becks Depression Inventory Scale vs. II (BDI 11). Data was collected for a two week period. Results: Of the potential participant sample (N=101) that accessed services 83.1% (n=84) indicated having one or more of the targeted physiological symptoms. BDI II scores for this group indicated that; 60.8 % (n=51) experienced the normal ups and downs of daily life, 20.2 % (n=17) scored for mild depression, 7.1 % (n=6) had borderline clinical depression and 11.9% (n=10) achieved a score indicating moderate depression. Common physiological symptoms reported included; headache (54.8%, n=46), general fatigue, cough (31%, n=26) and changes in appetite (26%, n=22).There was a medium positive correlation between total physiological symptoms and depression. Despite this, total physiological symptoms were not as strongly predictive of depression as the single physiological symptom of pain, specifically headache. Trends were suggested between depressive symptoms and; aged 20/21, cohabiting with partner, university educated, and employed. Conclusion and recommendation: Screening for depression within general health care facilities is relevant and recommended. Specific physiological symptoms, such as pain, should be recognised as potential indicators of depression, or risk for development of depression. General

health care workers need to be trained to use screening instruments and mhGAP interventional guidelines for prompt identification and management of depression in general health care facilities. It is recommended that all health care programmes include a mental health care module that includes screening for depression and suicide risk in order to build capacity within the general health care worker population.