Depression, anxiety, and stress symptoms in patients with cardiovascular diseases attending primary health care centers in Western Saudi Arabia: A cross-sectional study

Background: Cardiovascular diseases (CVDs) remain a major cause of mortality across the globe and are often accompanied by psychological distress, which may worsen disease outcomes. Aim: This study aimed to investigate the frequency and main predictors of depression, anxiety, and stress in patients with CVD. Settings and Design: Data were collected in primary health care centers (PHCCs) operated by the Ministry of National Guard Health Affairs in western Saudi Arabia. Methods and Materials: A cross-sectional study was conducted among adults with confirmed CVD. Psychological symptoms were assessed using the validated Arabic version of the Depression, Anxiety, and Stress Scale-21. Subscale scores were summed, categorized by standard severity levels, and analyzed using descriptive statistics and forward binary logistic regression to identify predictors exceeding the 'normal' range. Statistical Analysis Used: Data analysis was performed with IBM SPSS Statistics v31. Results: Among 420 CVD patients (mean age 57.3 ± 11.4; 45.5% female), depression, anxiety, and stress were present in 40.0%, 46.0%, and 30.0%, respectively, while 76.4% had at least one psychological distress symptom. Depression was more common in younger, female, or employed participants; anxiety in females or participants with non-CVD comorbidities or a family history of disability; and stress in participants with a family history of chronic disease or longer CVD duration. Medication adherence was protective across all outcomes. Conclusions: High rates of depression, anxiety, and stress were observed among patients with CVD. Routine psychological screening and structured psychosocial care within PHCCs are recommended.