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International Journal of Social Psychiatry
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Life Events Associated With Major Depression in Ugandan Primary Healthcare (PHC) Patients: Issues of Cultural Specificity

Wilson Winstons Muhwezi

Department of Psychiatry, Faculty of Medicine, Makerere University, Kampala, Uganda, wmuhwezi{at}med.mak.ac.ug

Hans Ågren

Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Karolinska University Hospital Huddinge, Stockholm, Sweden

Stella Neema

Makerere Institute of Social Research (MISR), Makerere University, Kampala, Uganda

Albert Koma Maganda

Paediatrics Infectious Disease Clinic, Mulago Hospital, Kampala, Uganda Seggane

Seggane Musisi

Department of Psychiatry, Faculty of Medicine, Makerere University, Kampala, Uganda

Objective: The study compared life events experienced by depressed patients seen at primary healthcare (PHC) centres with those among healthy community controls.

Method: Data was collected from 74 depressed patients and 64 unmatched controls from village locales of patients. Interview instruments included the depression module of the Mini International Neuropsychiatric Interview (MINI) and Interview for Recent Life Events (IRLE). Associations between type of respondent and demographic variables were examined. Statistical comparisons were done for the two groups on other variables.

Results: Most depressed patients were single by marital status, lacked formal employment and had less post-primary education.They had experienced more life events; job changes, discomforting working hours, unfavourable working conditions, and job losses; personal health problems; loss of valuables; difficulties with intimate partners and family members' marital problems. Independent life events were more among depressed patients and clustered around work, health, bereavement and marriage. Most events reported by depressed patients had high negative impact ratings compared to controls.

Conclusion: Compared to healthy community controls, depressed patients reported more undesirable life events. The relationship between life events and depression implies that in PHC settings of poor countries, deploying mental health-oriented workers to manage life events may lessen escalation of distress.

Key Words: depression • life events • primary healthcare • Uganda

International Journal of Social Psychiatry, Vol. 54, No. 2, 144-163 (2008)
DOI: 10.1177/0020764007083878
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