Physical Comorbidities in Depression Co-Occurring with Anxiety: A Cross Sectional Study in the Czech Primary Care System

Abstract

Comorbidities associated with depression have been researched in a number of contexts. However, the epidemiological situation in clinical practice is understudied, especially in the post-Communist Central and Eastern Europe region. The aim of this study was to assess physical comorbidities in depression, and to identify whether there are increased odds of physical comorbidities associated with co-occurring depressive and anxiety disorders. Data on 4264 patients aged 18–98 were collected among medical doctors in the Czech Republic between 2010 and 2011. Descriptive statistics were calculated and multiple logistic regressions were performed to assess comorbidities among patients with depressive disorder. There were 51.29% of those who have a physical comorbidity, and 45.5% of those who have a comorbid anxiety disorders among patients treated with depression in Czech primary care. Results of logistic regressions show that odds of having pain, hypertension or diabetes mellitus are particularly elevated at those who have co-occurring depressive and anxiety disorder. Our findings demonstrate that comorbidities associated with depressive disorders are highly prevalent in primary health care practice, and that physical comorbidities are particularly frequent among those with co-occurring depressive and anxiety disorders.

Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan

“…The magnitude of anxiety and depression is on the rise among the general population. Additionally, individuals with chronic diseases are at even higher risk of developing anxiety and depressive symptoms 3–6. In fact, depression has been ranked as the fourth leading cause of disease burden 7.…”

Frequency and correlates of depression at the primary health care level in Belgrade

“…depression precedes chronic illness [28]. Comorbidities associated with depressive disorders are highly prevalent in primary health care practice and a causal link between comorbid physical disorder and depression is yet to be studied [30].…”

Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

“…The difficulty is how we should view those physical symptoms: are they a parameter of the mental disorder or does the mental disorder influence the perceived severity of the physical disorders, or both? Winkler et al43 showed that in primary health care odds of having pain, hypertension, or diabetes mellitus are particularly elevated in people with co-occurring depressive and anxiety disorder. Especially for pain, it has been questioned whether there is a causal relationship with mental disorders, given the strong association between the two 44,45.…”