*Doctors call for high index of suspicion
By Chioma Obinna
THE growing incidence of suicide among Nigerians has become worrisome to the extent that psychiatrists and other physicians have called for high index of suspicion for signs and symptoms of depression among their patients.
They point to research which reveals that during their lifetime about 3.0 per cent of Nigerians will have thoughts about ending their lives, while some will plan on how to kill themselves and actually carry out an attempt to kill themselves.
According to the World Health Organisation, WHO, there are 322 million people living with depression in the world. In the WHO suicide ranking, Nigeria, with 15.1 suicides per 100,000 population per year, is ranked the 30th most suicide-prone out of 183 nations in the world.
Nigeria also rates 10th in Africa after countries with higher rates of suicide such as Togo (ranked 26th in the world), Burkina Faso (22nd), Cameroun (19th) Zimbabwe (16th), Central African Republic (13th), Sierra Leone (11th), Angola (9th), Equatorial Guinea (7th), and Cote D’Ívoire (5th).
Medical practitioners under the aegis of the Society of Family Physicians of Nigeria, SOFPON, raised the alarm that seven million Nigerians are living with depression, a major risk factor for suicide, and called for well structured Primary Healthcare Centres, PHCs, that would help detect and treat depression early before the onset of suicide attempts.
The President of SOFPON, Lagos Zone, Dr. Blessing Chukwukwelu noted: “In Nigeria, only one-fifth of those with a depressive episode receive any treatment, and only one in 50 receives treatment that is minimally adequate.
Primary care: “Therefore, there is the need for medical practitioners who see various cases of ailment at the Primary Health Centres to be trained on how to identify the symptoms of depression.
“The primary care is the sector that affects the health of the nation; so, preventing a condition at this level will not let it progress to the secondary level. When a physician takes a good history, he is able to diagnose the disorder; family physicians have the tools to tackle and also refer to the psychiatrist when he needs to,” she noted.
Chukwukelu said there is need to train family physicians continuously in order to close the gap in treatment of depression.
She maintained that family physicians see various cases at the primary healthcare level, hence, the need to observe high index of suspicion, while identifying awareness among Nigerians as key to reducing the scourge.
National President of SOFPON, Dr Akin Moses said a research carried out in 2015- 2016 showed that 29 million people in Africa were depressed while 322 million were affected with depression globally.
He said that the study showed that an estimated 788,000 suicide deaths worldwide occurred in 2015, while 10 suicide deaths per 100,000 population were recorded in Nigeria within the period.
Moses, said depression could occur when there were stressful conditions.
“As if stressful conditions are not sufficient, negative life events such as bereavement, job loss, financial difficulty, divorce, loneliness, childhood abuse and neglect can trigger depression,” Moses said.
He added that people with chronic pain, medical illnesses, caregiver burden, patients on certain drugs and those abusing substances such as cocaine and alcohol were at an increased risk of depression.
According to him, there are a few unfortunate suicide deaths in Nigeria which were attributed to severe stressful life events.
Moses observed that depression played a role in more than half of all suicide attempts and up to 15 per cent of those that were depressed died by suicide.
The physician said if not checked and treated, a depressed person has a 20 per cent chance of committing suicide.
On his part, a Family Physician and Chief Medical Director of Amazing Grace Medical Centre, Lagos, Dr Sylvester Osinowo, stressed the need for a paradigm shift in healthcare that requires 80 per cent functional PHCs to address the burden and deliver quality healthcare.
The Chairman, of the Association of General and Private Medical Practitioners of Nigeria, AGPMPN, Lagos Chapter, Dr Tunji Akintade, called for private/public collaboration in curbing depression.
“There is no reason why private hospitals across the country should have minimum of 10 or 20 beds unoccupied and you have a government hospital that has 60 or 70 beds all occupied. This is part of the challenges that the government needs to tackle.
Overview of depression:
According to experts, depression is a common illness worldwide. it s different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family.
It can lead to suicide which is the second cause of death in 15-29-year-olds.