Key result
Uncontrolled diabetes or hypertension is linked to ~150% higher odds of depression.
Why the study?
Depression is a common mental disorder that worsens prognosis in chronic diseases like diabetes mellitus and hypertension, but data from primary health center settings are limited.
What is the prevalence of depression and its associated factors among patients with diabetes and/or hypertension in a rural primary health center?
Cross-Sectional (n=210)
Simple random sampling
No
What is the prevalence of depression and its associated factors among patients with diabetes and/or hypertension in a rural primary health center?
Odds Ratio: 2.5 (95% CI 1.1–6.1)
Absolute Event Rate: 60.3% vs 30.4%
p-value: p=0.03
Nearly half of patients with diabetes or hypertension in a rural Indian primary care setting experience depression, which is strongly associated with uncontrolled disease, comorbidities, and COVID-19-related factors.
May warrant depression screening in rural DM/HTN care; cross-sectional data leaves causal direction and intervention effects open.
INTRODUCTION: Depression is among the most common mental disorders which is a leading cause of disability and is a negative prognostic indicator in many non-communicable chronic diseases such as diabetes mellitus (DM) and hypertension (HTN). Depression among these patients can further worsen their disease condition. Existing information on this topic has mostly come from tertiary care hospital setting. Hence, present study was done among patients attending a primary health center (PHC) in New Delhi. METHODS: This was a cross-sectional study conducted among 210 participants having diabetes and/or hypertension attending the non-communicable diseases (NCD) clinic at PHC, Fatehpur Beri, New Delhi. Simple random sampling was done and a pre-designed, semi-structured, interview-based questionnaire was used. Depression was assessed using a Patient Health Questionnaire-9 (PHQ-9). Data were analyzed using SPSS software version 21.0 (IBM Corp., Armonk, NY). RESULTS: The overall prevalence of depression was found to be 49% (n=103), out of which most had moderate depression (23.8%), 16.2% had moderately severe depression, and 9% had severe depression. Multivariate analysis results revealed the odds of having depression to be significantly higher among those who belonged to lower socioeconomic class (adjusted odds ratio, aOR=2.9, confidence interval, CI=1.2-7.4); had uncontrolled diabetes mellitus/hypertension (DM/HTN) (adjusted odds ratio, aOR=2.5, CI=1.1-6.1); had associated comorbidities (aOR=5.9, CI=2.4-15); sedentary lifestyle (aOR=7.8, CI=2.4-25.1); who had past history of coronavirus disease 2019 (COVID-19) infection (aOR=14.7, CI=5.4-39.6); and those who lost family member(s) due to COVID-19 (aOR=10.1, CI=1.3-79.4). CONCLUSION: Prevalence of depression in patients with DM/HTN was found to be significantly high and various factors were found to be significant. Therefore, every such patient should be screened for depression; and periodic follow ups should also be conducted to prevent future complications and improve prognosis of the disease.
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Sekhri et al. (2023) conducted a cross-sectional in Diabetes Mellitus and/or Hypertension (n=210). Uncontrolled diabetes mellitus and/or hypertension vs. Controlled diabetes mellitus and/or hypertension was evaluated on Depression (PHQ-9 score ≥ 10) (aOR 2.5, 95% CI 1.1-6.1, p=0.03). Uncontrolled diabetes mellitus and/or hypertension significantly increased the odds of depression (aOR 2.5) among patients attending a rural primary health center, where the overall prevalence of depression was 49%.
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