Depressive disorder in patients attending the outpatient department of a tertiary care hospital in Colombo.

INTRODUCTION: Lifetime prevalence of depression varies across countries and different populations. Depression is a common comorbidity of physical illness. Patients with depression are known to present with somatic symptoms. Depression is under-diagnosed in primary care settings. Objectives To estimate the prevalence of depression in patients attending the outpatient department (OPD) of a tertiary care hospital in the Western Province of Sri Lanka. METHODS: A cross-sectional descriptive study was conducted in the OPD of the National Hospital of Sri Lanka (NHSL). Sample size was 205. Every fifth patient aged between 18 and 60 years who attended the OPD was recruited until the required number was met. Centre for Epidemiologic Studies Depression Scale (CES-D) was used to identify depression. RESULTS: There were 114 (55.6%) females. Mean age was 50 years (SD 13.68).Overall prevalence of depression in the sample was 22.4% (95% CI 16.68-28.20). Prevalence of depression was higher among females 25.4% (95% CI 17.32-33.56) than in males 18.7% (95% CI 10.52- 26.84). Prevalence of severe depression was 15.1% (95% CI 10.18-20.07). Adjusted odds ratios showed that pain related presenting complaints were significantly associated with depression [adjusted OR 1.99 (95% CI 1.01-3.96)]. CONCLUSIONS: Prevalence of depression in outpatients is similar to that reported in other parts of the world. None of the patients with depression presented seeking help for depressive symptoms.

Validation of the Sinhala version of the Pittsburgh Sleep Quality Index.

INTRODUCTION: Pittsburg Sleep Quality Index (PSQI) is a widely used standardized instrument to assess sleep quality in clinical and research settings. Objective of the study was to translate the PSQI into Sinhala language and validate using a combined qualitative and quantitative approach. METHODS: Every fifth patient aged 18-60 years who attended the out-patients department of a tertiary care hospital was recruited. PSQI was translated into Sinhala using a combined qualitative and quantitative approach. Internal consistency was measured using Cronbach's alpha. Construct validity was assessed by comparing the scores in patients who were identified as having depressive disorder according to the Centre for Epidemiologic Studies Depression Scale (CES-D) and those without depressive disorder. RESULTS: Forty-six participants with depression were compared with 159 non depressed controls. Mean PSQI component scores were significantly higher in depressed patients in 5 components. Factor analysis identified a single component explaining 53.53% of the variance. Cronbach's alpha of 0.85 indicated a high internal consistency. CONCLUSIONS: The Sinhala translation of the PSQI is a valid and reliable tool to assess sleep quality.