Depression among medical residents in Dar es salaam, Tanzania

Date of Award

2021

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

DR. Eric Aghan

Second Supervisor/Advisor

DR. Tumbwene Mwansisya

Third Supervisor/Advisor

DR. Riaz Ratansi

Department

Medical College (East Africa)

Abstract

Background: Depression is the commonest mental illness that affects people in all communities worldwide. Studies have described that medical residents experience higher rates of depression than the public. Several extra factors may account for these higher rates of depression. The potential effects of depression include impairments of both academic and clinical performance. For these reasons, the demand for curbing depression especially in this group is vital.

Objectives: The primary objective was to assess the prevalence of depression among medical residents in Dar es salaam, Tanzania. The secondary objective was to assess the severity of depression among medical residents, to assess the factors that are associated with depression among medical residents, to assess the diagnostic accuracy of the Patient Health Questionnaire on screening for depression among medical residents in Dar es salaam, Tanzania.

Methods: A cross-sectional analytical study was carried out at the 3 institutions in Dar es Salaam, Tanzania; Aga Khan University, Muhimbili University of Health and Allied Science, and Hubert Kairuki Memorial University. Using a self-administered questionnaire (demographic details, associated factors, and a Patient Health Questionnaire – 9) and a clinical interview (Diagnostic Statistical Manual Fifth Edition criteria). The prevalence of participants with depression was determined, the severity of depression was calculated, Chi-square and odd ratios with 95% confidence interval were used for associated factors and diagnostic accuracy measurements were used.

Results: The prevalence of depression among medical residents in Dar es Salaam, Tanzania was 4% (8/201). Among the eight participants with depression, three (1.5%) were males and five (2.5%) were females. The severity of depression among the eight participants ranges from mild 12.5%, moderate 50%, moderate-severe 25%, and severe 12.5%. Only working hours more than 72 hours per week was statistically significant (OR 7.07, 95% CI 0.85 – 58.58, P = 0.036). Several other factors were not statistically significantly associated with depression. The diagnostic accuracy of the Patient Health Questionnaire – 9 questionnaire on screening for depression among medical residents was best at the Patient Health Questionnaire – 9 cut-off score of ≥ 10. (Sn=87.5%, Sp=88%, +LR = 8.39)

Conclusion and recommendations: The rate of depression among medical residents is significant. Institutions with residency programs have to address depression as a problem and consider screening by using Patient Health Questionnaire - 9. Furthermore, studies are needed to assess these factors thoroughly, as this information can vitally enhance interventions on preventing depression among medical residents in our setting.

This document is available in the relevant AKU library

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