Anxiety, Depression, and Common Chronic Diseases, and Their Association With Social Determinants in Saudi Primary Care

• Published in: Journal of primary care & community health 2021-11, Vol.12, p.21501327211054987
• Main Authors: Baghdadi, Leena R., Alhassan, Mohammed Khalid, Alotaibi, Fawaz Hindi, AlSelaim, Khalid Badr, Alzahrani, Abdulrahman Abdulkhaliq, AlMusaeed, Faisal Fahad
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxiety - epidemiology; Cholesterol; Chronic Disease; Chronic illnesses; Cross-Sectional Studies; Demography; Depression - epidemiology; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Drinks; Humans; Hypertension; Lifestyles; Mental depression; Middle Aged; Original Research; Outpatient clinics; Physical activity; Primary care; Primary Health Care; Psychological status; Rheumatoid arthritis; Saudi Arabia - epidemiology; Social anxiety; Social Determinants of Health; Social factors; Sociodemographics; Type 2 diabetes mellitus
• ISSN: 2150-1319; 2150-1327; 2150-1327
• DOI: 10.1177/21501327211054987

Introduction: Patients with chronic diseases can experience psychological conditions, including anxiety and depression. However, the association between chronic diseases and these psychological conditions remains unclear. This study aimed to identify the relationship between anxiety, depression, and common chronic diseases (hypertension, type 2 diabetes, dyslipidemia, and rheumatoid arthritis), and their association with social determinants at an outpatient primary care setting. Methods: The validated hospital anxiety and depression scale was administered electronically to eligible participants. For each condition (anxiety and depression), participants were categorized as normal, borderline abnormal, and abnormal, according to their score out of 21 (≤7 = normal, 8-10 = borderline abnormal, ≥11 = abnormal). The scores and numbers of participants in each category were analyzed and compared with their demographic characteristics and chronic diseases for associations and relationships. Results: We recruited 271 participants (mean age of 51.65 + 11.71 years) attending primary care clinics. Of these patients, 17.7% and 8.9% had borderline abnormal and abnormal depression, respectively, and 10.3% and 8.9% of patients had borderline abnormal anxiety and abnormal anxiety. Common social determinants and lifestyle factors were examined. Age, gender, and sugary drinks’ consumption significantly increased the odds of hypertension and type 2 diabetes; vigorous physical activity 3 times a week, decreased the odds of developing these chronic diseases. Adjusted regression models showed a statistically significant association between the hospital anxiety and depression scale score for borderline and abnormal anxiety and the presence of type 2 diabetes (OR 3.04 [95% CI 1.13, 8.19], P-value = .03 and OR 4.65 [95% CI 1.63,13.22], P-value