The prevalence of depression and associated factors in Ethiopia: findings from the National Health Survey

BACKGROUND: Integrating mental health into primarily health care and studying risk for mental health particularly depression needs assessment of different factors including those that impede diagnosis and treatment of mental disorders. But so far the numbers of literature for local context to analyze risk factors for depression and its treatment are scare. The objective of this study was to assess risk factors and health service attendance for depression among adults, in Ethiopia. METHODS: For this analysis, data from the Ethiopian National health survey was used. The Ethiopian national health survey studied 4,925 adults aged 18 years and older to obtain among other things, data on depression episodes, socio-demographic, chronic diseases, life style factors and treatment receiving for depression episodes in the past twelve months using questionnaire from world health organization (WHO). Prevalence of Depression in respondents based on ICD-10 criteria was estimated and logistic regression analysis was used to identify risk factors for depression and treatment receiving. RESULTS: The prevalence of depressive episode was 9.1% (95% CI: 8.39-9.90). In a Univariate analysis, residence, age, marital status, educational status, number of diagnosed chronic non communicable diseases (heart diseases, diabetic mellitus and arthritis) and alcohol drinking status were associated with depression. After full adjustment for possible confounding, odds ratios for depression were significantly higher only for older age, divorced and widowed, number of diagnosed chronic non communicable diseases and alcohol drinking status. The proportion of attending health service among those with depression episodes was 22.9%. After full control for all socio-demographic variables the only predictor variable was educational status, being in grade 5–8 had a higher odds (OR=2.6, 95% CI: 1.23-5.43) and 9–12 grade (OR=1.8 95% CI: 1.45-6.12) of attending service for depressive episodes. CONCLUSIONS: Age, marital status, number of diagnosed chronic non communicable diseases and alcohol consumption were the most important risk factors for depressive episodes. Generally there was lower use of health service for depressive episodes and low educational status was found to be barriers for service use. There is a need to formulate policy for mental health and training of primary health care workers in mental health to early identify and treat cases with depression episodes, so as to decrease prevalence of depression episodes and to improve accessibility of service use.