Some Observations on Depressive Illness in Nigerians: Attending a Psychiatric Out-Patients Clinic

Abstract

Some of the clinical features of depressive illness in twenty-five Nigerian out-patients (eleven males and fourteen females) making contact for the first time with a psychiatrist at the University College Hospital Ibadan, over a 7-month period are presented. The relevant data are collected in such a way as to make a distinction between symptoms volunteered by, and those admitted to, or denied by, the patients. The usual manifestations of depression (including suicidal thoughts and act) were elicited to varying extents in a high proportion of the patients. Severe psychotic depression with marked psychomotor retardation, ideas of guilt and unworthiness was rarely encountered. Somatic symptoms (usually multiple) were prominent and volunteered, but psychological ones, were elicited usually on questioning. Twenty-four out of the twenty-five patients volunteered or admitted to sadness of mood, but most of them attributed this to their somatic symptoms. The possible reasons for this mode of presentation are discussed. The study underlines the need to elicit psychological symptoms by questioning patients and the need for medical practitioners to be aware that depressed patients might 'masquerade' in their clinics as suffering from a physical illness. The need for more work in this area is emphasized