West Indian Med J 2005; 54 (6): 369 Depression and its Associated Factors among Patients Attending Chronic Disease Clinics in Southwest Trinidad RG Maharaj 1 , SD Reid 2 , A Misir 3 , DT Simeon 4 ABSTRACT This study determined the prevalence of depression and associated factors, among patients attending chronic disease clinics in Southwest Trinidad. This was a cross- sectional survey using a sample of consecutive patients at four large clinics. To determine the presence of depression, an interviewer- applied modified Zung Scale was validated. The modified Zung scale, at the cut-off index of 60, has a sensitivity of 60% and a specificity of 94%. Seven hundred and thirty-four completed questionnaires were received, a response rate of 76%. The patients were primarily Indo-Trinidadian (70%), over 50 years (76.4%) and female (72.3%). The prevalence of depression was 28.3%. There were statistically significant differences in the level of depression by age, gender, educational level achieved and occupation (p < 0.05). There were also statistically significant differences in the level of depression by the number of presenting complaints, the number of chronic diseases, the presence of arthritis, the presence of diabetes mellitus with another chronic disease and the presence of ischaemic heart disease (p < 0.05). No significant differences were found with respect to ethnicity (p = 0.97) or the presence of diabetes mellitus by itself (p = 0.34). Results of logistic regression indicate that the independent predictors of depression (p < 0.05) were the level of education achieved, those with higher levels of education had less depression; the number of presenting complaints, those with more presenting complaints were more likely to be depressed and the presence of arthritis and female gender. It is imperative that policy be developed to address the mental health problems of patients attending these chronic disease clinics. La Depresión y sus Factores Asociados entre los Pacientes que Asisten a las Clínicas de Enfermedades Crónicas en el Suroeste de Trinidad RG Maharaj 1 , SD Reid 2 , A Misir 3 , D Simeon 4 RESUMEN Este estudio determinó la prevalencia de la depresión y los factores asociados con ella, entre los pacientes que asisten a las clínicas en el suroeste de Trinidad. El mismo consistió en una encuesta transversal que utiliza una muestra de pacientes consecutivos en cuatro clínicas grandes. A fin de determinar la presencia de la depresión, validamos una escala de depresión de Zung modificada y aplicada por un entrevistador. La escala de Zung modificada, a un índice límite de 60, tiene una sensibilidad de 60% y una especificidad de 94%. Se recibieron setecientos treinta y cuatro cuestion- arios respondidos, lo que equivale a una tasa de respuesta de 76%. Los pacientes fueron funda- mentalmente indotrinitenses (70%), mayores de 50 años (76.4%) y mujeres (72.3%). La prevalencia de la depresión fue 28.3%. Hubo diferencias estadísticas significativas en el nivel de depresión por edad, sexo, nivel educacional alcanzado, y ocupación (p < 0.05). Hubo también diferencias estadísticamente significativas en el nivel de depresión por el número de quejas que se presentaban, el número de enfer- medades crónicas, la presencia de artritis, la presencia de diabetes mellitus junto con otras enferme- dades crónicas, y la presencia de cardiopatías isquémicas (p < 0.05). No se hallaron diferencias sig- From: Department of Paraclinical Sciences, Public Health and Primary Care Unit 1 , The Faculty of Medical Sciences 2 , The University of the West Indies 4 , St Augustine, Trinidad and Tobago, and Southwest Regional Health Authority 3 , Trinidad and Tobago. Correspondence: Dr R Maharaj, Department of Paraclinical Sciences, Public Health and Primary Care Unit, The Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago, West Indies. Fax: (868) 645-6741, e-mail: <rmaharaj@fms.uwi.tt>