Association between depression, anxiety and quality of life among patients with diabetes mellitus and/or hypertension in a tertiary care railway hospital in India: A cross-sectional study

Abstract

Introduction: Comorbid depression and anxiety have been found to be highly present in patients suffering from chronic physical illnesses such as diabetes mellitus (DM) and hypertension (HTN). These comorbid psychiatric conditions further reduce the quality of life (QOL) in the sufferers. The present study aimed to assess the association between depression, anxiety, and QOL among patients with DM and/or HTN. Materials and Methods: This cross-sectional study was carried out in the outpatient setting of the medicine department of the tertiary care referral hospital of East Central Indian Railways. One hundred and twenty-three individuals of DM and/or HTN of more than 1-month duration were assessed for depression, anxiety, and QOL using the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization QOL Brief (WHOQOL-BREF) version scale. Results: The mean age of the sample (53.7% had HTN, 12.2% had diabetes, and 34.1% had both HTN and diabetes) which comprised 87% males was 50.20 (±6.0) years. The mean HADS (anxiety and depression) scores were 3.6 for both (range 0–14). Nearly 10.6% and 17.1% of the samples had scores above the cutoff for HADS anxiety and depression subscales. The WHOQOL-BREF scores were highest for the environmental domain and were lower for psychological, physical, and social domains. The HADS anxiety and depressive scores correlated significantly negatively with the WHOQOL-BREF physical and psychological domains. Female gender and the presence of an additional medical illness were significantly associated with higher HADS depression scores. Conclusion: Fair proportion of patients with HTN and/or diabetes has been affected with higher anxiety and depressive scores, which predicted a poor QOL. This calls for early identification of these mental health issues in sufferers of depression and HTN, which will facilitate an early holistic management.

Association of depression and anxiety with uncontrolled hypertension: A cross-sectional study in Southwest Nigeria

“…[ 4 ] This reaffirms that anxiety and depression are common comorbidities among patients who have hypertension. [ 4 23 44 ] In addition, depression and anxiety were found among middle-aged adults and the elderly and this was consistent with the findings of a study in Afghanistan among adults with hypertension. [ 45 ] The study attributed this finding to the poor level of mental health services and facilities, in addition to the delay in accessing health care due to cost, especially in LMICs resulting in the challenge of diagnosing depression and anxiety at their onset among younger age.…”

“…[ 30 31 ] The proportion of respondents with symptoms of anxiety or depression in this study is similar to that in a study among patients with diabetes mellitus and hypertension in India. [ 4 ] This reaffirms that anxiety and depression are common comorbidities among patients who have hypertension. [ 4 23 44 ] In addition, depression and anxiety were found among middle-aged adults and the elderly and this was consistent with the findings of a study in Afghanistan among adults with hypertension.…”

“…[ 2 3 ] Some studies conducted in India, the United States of America (USA), and Pakistan have demonstrated an association between mental health disorders, and some established cardiovascular disease risk factors. [ 4 5 6 7 ] However, the relationship between hypertension and psychological disorders has been quite a contentious issue, with diverse findings being reported by different studies. [ 8 ] Globally, depressive and anxiety disorders are the most common psychiatric diseases[ 9 ] and they are the leading causes of disability globally, contributing significantly to the overall global burden of disease.…”

Association of physical activity and stress reactivity with depression in elderly hypertensive population: A cross-sectional study from Eastern India

“…It is said to be one of the best screening tools used in older adults with depression, with sensitivity in the range of 86%-91% and specificity in the range of 84%-90%. [ 6 , 7 , 8 ]…”

Social anxiety, self‐esteem and quality of life among hypertensive patients during COVID‐19 local epidemic in China: A mediation analysis

“…Such as self‐esteem and social activities, which are important contributors to the “well‐being” dimension of QoL (Kermode & MacLean, 2001). Normally, the QoL of hypertensive patients is worse than that of ordinary people, especially those with poor psychological status and higher age (Ranjan et al., 2020; Riley et al., 2019). It affected patients' disease management, made them difficult to control blood pressure and could also negatively influence psychology.…”