Association of chronic diseases with depression, anxiety and stress in Chinese general population: The CHCN-BTH cohort study

• Published in: Journal of affective disorders 2021-03, Vol.282, p.1278-1287
• Main Authors: Liu, Xiaohui, Cao, Han, Zhu, Huiping, Zhang, Han, Niu, Kaijun, Tang, Naijun, Cui, Ze, Pan, Li, Yao, Changqiang, Gao, Qi, Wang, Zhengfang, Sun, Jixin, He, Huijing, Guo, Ming, Guo, Chunyue, Liu, Kuo, Peng, Hai, Peng, Wenjuan, Sun, Yanyan, Xie, Yunyi, Li, Bingxiao, Shan, Guangliang, Zhang, Ling
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxiety - epidemiology; Beijing; China - epidemiology; Chronic Disease; Cohort Studies; Cross-Sectional Studies; DASS-21; Depression; Depression - epidemiology; Humans; Non-communicable chronic diseases; Prevalence; Stress; Stress, Psychological - epidemiology; Surveys and Questionnaires
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2021.01.040

•Psychological symptoms were more prevalent among NCDs in Chinese general population.•The multi-morbidities had higher risk of psychological symptoms.•Course of disease more than 5 years also had higher risk of psychological symptoms.•Associations of NCDs with psychological symptoms were stronger for female, the elderly, never smoking, never drinking, unmarried, low income and education. Background Large-scale epidemiological surveys focusing on characteristic differences in psychological and physical health conditions in Chinese adults are lacking. Objective To investigate the association of noncommunicable chronic diseases (NCDs) with depression, anxiety and stress in the Chinese general population. Methods A total of 13784 participants were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) from 2017 to 2019. Sociodemographic characteristics, lifestyle and NCDs were assessed via questionnaire. Stress, anxiety and depression were assessed by the Depression-Anxiety-Stress Scale (DASS-21). The relationship of NCDs with psychological symptoms was determined through logistic regression analysis. Results Multivariate logistic regression analysis revealed that the prevalence of stress (OR = 1.640; 95% CI: 1.381–1.949), anxiety (OR = 1.654; 95% CI: 1.490–1.837) and depression (OR = 1.460; 95% CI: 1.286–1.658) symptoms were all significantly higher in patients with NCDs. Multimorbidities were associated with a higher risk of stress (OR = 2.310; 95% CI: 1.820–2.931), anxiety (OR = 2.119; 95% CI: 1.844–2.436) and depression (OR = 2.785; 95% CI: 1.499–2.126) than single NCDs. A course of disease within 1 year or more than 5 years also was associated with a higher risk. Limitations The cross-sectional design could not examine the causal link between psychological symptoms and NCDs. Conclusion Psychological symptoms were more prevalent among individuals with NCDs in the Chinese general population. This study suggests that more attention should be paid to the mental health problems of patients with NCDs.