Prevalence of Depressive Illness among Patients with Asthmatic Disease Attending the University of Port Harcourt Teaching Hospital (UPTH)

Abstract

Background: Asthma is a chronic distressing respiratory disease which occurs in all ages. It is inheritable but can be largely caused, precipitated and/or maintained by a number of environmental factors such as nature of occupation, inhaled substances including dust and other toxicants as well as stress. Depressive illness is mood disorder characterized by core symptoms of low mood, loss of interest, reduced energy level, impairment in social, occupational and interpersonal functions. It may be mild, moderate or severe with or without psychotic features. Many sufferers of asthmatic diseases tend to have co morbid depressive illness of variable severity due to the psychological/emotional burden associated with the disease. There is currently a paucity of data on the exact prevalence of depressive illness associated with patients with Asthma in this environment. The aim of this study was to determine the prevalence of depressive illness in patients with asthmatic disease attending the University of Port Harcourt Teaching Hospital (UPTH).

Methods: Consent for the study was obtained from the Ethical Committee of the hospital. Patients for the study were recruited from the Accident and Emergency Department, the Respiratory Units of Internal Medicine, Family Medicine and Pediatrics respective Departments. All asthmatic patients with another medical disease were excluded from the study. Asthmatics patients recruited were only those diagnosed by Consultant Physicians in the Departments of study, who have been on treatment for at least a period of 6 months. Also, subjects whose psychiatric illness preceded the asthmatic disease were equally excluded from the study. Asocio-demographic questionnaire as well as the Beck's Depressive Inventory (BDI) was used as study instruments. The data obtained were analyzed using the SPSS version 20. Confidence interval was set at 95% and a P value of less than 0.05 was considered statistically significant.

Results: A total of 46 patients were enlisted into the study, 27 males and 19 females. The average age was 28.6±2 years. 57% were students of which 68% of them were of tertiary institutions. Out of the total number of 46 patients, 31(67.4%) of them were found to have depressive illness (56% mild, 29% moderate and 15% had major depressive illness).5 patients representing 10.9% had suicidal ideation and 2(4.3%) had actually attempted suicide at least on two occasions. 65% mostly of the mild depressive illness were not aware of their mental ill-health. Only 9% of those who were aware of their psychiatric condition had sought psychiatric intervention.

Conclusion: From the study, the prevalence of depressive illness among asthmatic patients in UPTH is high and many of the patients appear unfortunately not to receive appropriately treatment as diagnosis and referral are still relatively inadequate and imprecise. There is therefore, great need for awareness of the existence of this comorbidity as well as institution of appropriate identification measures and subsequent referral for appropriate treatment. This will undoubtedly improve the management of asthmatics as well as their quality of life.