BACKGROUND: We sought to assess the prevalence of major depression in a region of sub-Saharan Africa severely affected by HIV, using symptom and functional criteria as measured with locally validated instruments. METHOD: Six hundred homes in the Masaka and Rakai districts of southwest Uganda were selected by weighted systematic random sampling. A locally validated version of the depression section of the Hopkins Symptom Check List (DHSCL) and a community-generated index of functional impairment were used to interview 587 respondents. RESULTS: Of respondents, 21% were diagnosed with depression using three of the five DSM-IV criteria (including function impairment) compared with 24.4% using symptom criteria alone. Increased age and lower educational levels are associated with a greater risk for depression; however, a gender effect was not detected. CONCLUSIONS: Most community-based assessments of depression in sub-Saharan Africa based on the DSM-IV have used symptom criteria only. We found that expanding criteria to more closely match the complete DSM-IV is feasible, thereby making more accurate assessments of prevalence possible. This approach suggests that major depression and associated functional impairment are a substantial problem in this population.
BACKGROUND: We sought to assess the prevalence of major depression in a region of sub-Saharan Africa severely affected by HIV, using symptom and functional criteria as measured with locally validated instruments. METHOD: Six hundred homes in the Masaka and Rakai districts of southwest Uganda were selected by weighted systematic random sampling. A locally validated version of the depression section of the Hopkins Symptom Check List (DHSCL) and a community-generated index of functional impairment were used to interview 587 respondents. RESULTS: Of respondents, 21% were diagnosed with depression using three of the five DSM-IV criteria (including function impairment) compared with 24.4% using symptom criteria alone. Increased age and lower educational levels are associated with a greater risk for depression; however, a gender effect was not detected. CONCLUSIONS: Most community-based assessments of depression in sub-Saharan Africa based on the DSM-IV have used symptom criteria only. We found that expanding criteria to more closely match the complete DSM-IV is feasible, thereby making more accurate assessments of prevalence possible. This approach suggests that major depression and associated functional impairment are a substantial problem in this population.
Authors: Jane M Simoni; Steven A Safren; Lisa E Manhart; Karen Lyda; Cynthia I Grossman; Deepa Rao; Matthew J Mimiaga; Frank Y Wong; Sheryl L Catz; Michael B Blank; Ralph DiClemente; Ira B Wilson Journal: AIDS Behav Date: 2011-02
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