Undiagnosed Depression among Hypertensive Individuals in Gaza: A Cross-sectional Survey from Palestine

Abstract

Background The aim of this study was to estimate the prevalence and to determine the associated factors of undiagnosed depression amongst hypertensive patients (HTNP) at primary health care centers (PHCC) in Gaza. Methods A cross-sectional survey was conducted including 538 HTNP as a recruitment phase of a clustered randomized controlled trial. Data were collected through a face to face structured interview and depression status was assessed by Beck's Depression Inventory (BDI-II). Data were analyzed by STATA version 14 using standard complex survey analyses, accounted for unresponsiveness and clustering approach. Linear regression analysis was performed to assess associations. Results The prevalence of undiagnosed clinical depression was 11.6% (95% confidence interval [CI]: 8.1, 16.3). Moreover, prevalence of 15.4% (95% CI: 10.8, 21.6) was found for mild depression symptoms. We found that non-adherent to antihypertensive medications (AHTNM) (β = 0.9, 95% CI: 0.17, 1.7), having more health-care system support (β = 2.8, 95% CI: 1.6, 3.9) and number of AHTNM (β = 1.5, 95% CI: 0.6, 2.5) remain significantly positive associated with BDI-II score. While, older age (β = -0.1, 95% CI: -0.2, -0.02), having better social support (β = -6.8, 95% CI: -8.9, -4.7) and having stronger patient-doctor relationship (β = -4.1, 95% CI: -6.9, -1.2) kept significantly negative association. Conclusion The prevalence of undiagnosed depression was about one-quarter of all cases; half of them were moderate to severe. Routine screening of depression status should be a part of care of HTNP in PHCC.

Frequency of Depressive Symptoms among Hypertensive Patients Attending Family Medicine Outpatient Clinic at Suez Canal University Hospitals

“…These results support the development and dissemination of integrative care approaches for older adults with hypertension. A Cross-sectional Survey from Palestine (31) reported that the prevalence of undiagnosed clinical depression was 11.6%. In addition, the prevalence of 15.4% was found for mild depression symptoms.…”