Common Symptoms of Depression among Patients with Depressive Disorders Receiving Outpatient Care in Tertiary Hospitals in A.A., Ethiopia:A Cross Sectional Study

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Addis Ababa University


Background The major assessment tool that is of use in Ethiopia to diagnose and treat depressive disorders is DSM 5. However, DSM -5 might not represent the diverse symptomatology of depression in a country with diverse ethnic and cultural background. Having a clear knowledge of the type of common presentations or complaints of patients with depression coming to outpatient services in tertiary hospitals has significant implication for clinicians to provide appropriate patient care. Objective To identify the common presenting symptoms of depressive disorders among patients who came to receive outpatient care for depressive disorders in tertiary hospitals in Addis Ababa. Another objective is to identify common symptoms along the domains and to investigate its association with sociodemographic factors of the study participants. Method A cross sectional facility-based study design was used. The study participants included patients who visited outpatient psychiatric services in 3 tertiary hospitals in Addis Ababa in the past 2 years, by mainly focusing on patients who are currently visiting the OPDs and going back up to 2 years until the sample size was reached. Potentially eligible patients were selected by filtering those who have been diagnosed with depressive disorders. Then, using the inclusion and exclusion criteria samples were identified until the sample size which was needed reached starting from the most recently recorded patient (consecutive sampling). Consecutive patients were recruited starting from those currently on follow up to until about those who were seen in the past 2 years at least once. Study participants were interviewed through Face to Face interview. Descriptive statistical methods were used to summarize the collected data and to help us understand the collected information. The most distressing symptom domains were analyzed. Cross tabulation was done to see association between sociodemographic and symptom domains. Results- Feeling down, depressed or hopeless were the most frequently endorsed symptoms occurring in >90% of the patients. All items were rated with fainting spells being the lowest rated occurring in only 10.9% of the patients. At least one symptom was seen in 98.8% of them from somatic domain, 96.4% from affective, 93.3% from other and 78.2% from cognitive domains. From the patients who reported most distressing symptoms, around 58(35.2%) of them mentioned symptoms from the affective domain as their most distressing symptom, 46(27.8%) mentioned symptoms from somatic domain, 21(12.7%) mentioned two or more symptom combinations from different domains, 12(7.2%) from cognitive and 1(0.6%) from other domain. Conclusion- Above 90 % of the study participants reported to have symptoms from the 3 domains of depression which are affective, somatic, and other. Around 78% of the patients also reported to have one or more symptoms from cognitive domain of depression. When expressing symptoms which are most distressing to them, significant proportion of the patients reported symptoms which are combinations from all the 4 domains of depression. Symptoms which are not included in DSM criteria and screening tools being used in clinical setup are shown to be reported in high frequency and also as most distressing in this study.



Depression,Patients,depressive disorders