Prevalence of Undetected Depression Among Adult Dermatology Outpatients Attending the Dermatology Outpatient Clinic at Kenyatta National Hospital

Abstract

Background: Several studies have found co-morbid depression in patients afflicted with skin diseases. Most of these studies have been conducted in Europe and Asia populations. Local studies are necessary to generate knowledge of the true extent of undetected depression among adult dermatology out-patients in Kenyatta National Hospital, Nairobi, Kenya Aim: The principal objective was to investigate the prevalence rates of undetected depression and associated factors among dermatology patients who sought medical care in the dermatology outpatient clinic in Kenyatta National Hospital, Nairobi, Kenya Study design: The research adopted a cross-sectional descriptive hospital-based design that was carried out on 145 adult dermatology patients attending Kenyatta National Hospital Dermatology outpatient clinic. A convenience sampling method was used. The researcher utilized PHQ-9 and a socio-demographic questionnaire that was custom-made to collect data. Data analysis: Data was entered into Microsoft Excel, cleaned and analysed using the statistical package for the social sciences (SPSS) version 27.0. Categorical variables (clinical and sociodemographic data) were presented in pie charts and frequency tables while median, mean and standard deviation were determined for (age) continuous variable. At the bivariate level, the association between variables and depression was determined by the use of the chisquare test. At the multivariate level, variables that were significant at the bivariate level were adjusted to determine independent predictors of depression. Logical regression was used at the multivariate stage. P<0.05 was deemed statistically significant. Results: The extent of depression among patients with skin disorders was 29.7%. Among the dermatology outpatients with comorbid clinical depression,15.2%(n=22) had moderate depression, while 11% (n=16) had moderately severe depression and 3.4% (n=5) had severe

depression. Depression was statistically significant among unemployed (A.O.R=15.27,95% C.I:1.38,168.8)p=0.04 and patients who had a family member diagnosed with mental illness(A.O.R=9.2,95%C.I:1.815,46.82)p=0.007. Independent predictors of depression for the dermatology patients were having a family member with a history of mental illness(p=0.04) and being unemployed(p=0.007). Conclusion: The study revealed that a significant proportion of dermatology outpatients have comorbid depression, which frequently remains undetected in routine clinical practice. The findings underscore the importance of heightened surveillance of depression and integration of timely screening and treatment of psychiatric illnesses into the routine care of dermatology patients.