Abstract:
More is not known about depression rates in internal medicine outpatients consulting the
teaching hospitals in Rwanda. The descriptive cross-sectional study was used to determine
the prevalence of depression and associated factors among internal medicine outpatients of
Kigali university teaching hospital (CHUK). The 9 items Patient Health Questionnaire
(PHQ-9) instrument was used to screen depression symptoms among outpatients. The
validated cut-off score of 10 for diagnosing depression was applied in this study. Patients’
clinical and socio-demographic characteristics were collected and analyzed for their
relationship with depression. Three hundred patients were recruited, of whom 65.3%) were
females and 51% had age between 45 and 96 years. The overall prevalence of depression
among outpatients in the internal medicine department of CHUK was 45.7%. Outpatients
had 20.7%, 17% and 10% for moderate, moderately severe and severe depression,
respectively. Age, educational status and follow up visits as current physical complaints
were independently associated with depression. As much as 22.7% of patients were
presenting with Suicidal ideas. The study showed that low income was strongly associated
with suicide ideation. Regardless of age and gender, prevalence of depression was higher
among outpatients of internal medicine than the general population. All patients who
scored PHQ-9 above 10 were referred to CHUK mental health department for appropriate
management. A holistic approach in the management of internal medicine outpatients
should be implemented to facilitate the early detection and treatment of depression in
general tertiary hospitals. Furthermore, intervention programs that address the depression
and suicide in adults are needed.
