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Boukhari FZ, Belayachi S, Essayagh F, Terkiba O, Naji AA, Amine M, Lambaki A, Essayagh M, Essayagh S, Essayagh T. Self-reported depression and its risk factors among hypertensive patients, Morocco: a cross-sectional study. Sci Rep 2024; 14:11196. [PMID: 38755268 PMCID: PMC11099232 DOI: 10.1038/s41598-024-61390-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
Hypertensive patients are at an elevated risk of developing mental diseases such as depression, which can impair their quality of life. The purpose of this study is to measure the prevalence of self-reported depression among hypertensive patients treated at primary health care facilities in Marrakech. Between May 2021 and December 2022, a cross-sectional study of 1053 hypertensive patients attending primary health care facilities in Marrakech was conducted. A face-to-face questionnaire was used to collect socio-demographic, behavioral, and clinical data, as well as hypertension treatment characteristics and the care-patient-physician triad. The Patient Health Questionnaire-9 was used to assess self-reported depression. To identify self-reported depression risk factors, multivariate logistic regression was used. Depressive symptoms were reported by 56.1% of hypertensive patients. The patients' average age was 63.2 ± 9.5 years, and 508 (85.9%) were female. Female sex, stress, a low-salt diet, pain and physical discomfort, an urban living environment, a lack of self-monitoring of hypertension, an unsatisfactory relationship with the healthcare system, a family history of hypertension, and the perception of adverse effects of the antihypertensive drug were all associated with self-reported depression. Self-reported depression is prevalent among hypertensive patients in Marrakech. The mental health component should be emphasized while addressing hypertensive patients in primary health care facilities.
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Affiliation(s)
- Fatima Zahra Boukhari
- Faculté des sciences et techniques, Laboratoire agroalimentaire et santé, Hassan First University of Settat, Settat, Morocco
| | - Safae Belayachi
- Faculté des sciences et techniques, Laboratoire agroalimentaire et santé, Hassan First University of Settat, Settat, Morocco
| | - Firdaous Essayagh
- Faculté des sciences juridiques, économiques et sociales, Laboratoire droit privé et enjeux de développement, Université Sidi Mohamed Ben Abdellah, Fès, Morocco
| | - Othmane Terkiba
- Institut supérieur des sciences de la santé, Laboratoire sciences et technologies de la santé, Hassan First University of Settat, Settat, Morocco
| | - Ahmed Anouar Naji
- Faculté des sciences juridiques, économiques et sociales, Laboratoire droit privé et enjeux de développement, Université Sidi Mohamed Ben Abdellah, Fès, Morocco
| | - Mohammed Amine
- Faculty of medicine and pharmacy, Clinical research service, Mohammed VI university hospital center, Department of public health, epidemiology and community medicine, Laboratory of biosciences and health, Cadi Ayyad University, Marrakech, Morocco
| | - Abdellah Lambaki
- Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.
| | - Meriem Essayagh
- Office national de sécurité sanitaire des produits alimentaires, Oriental, Morocco
| | - Sanah Essayagh
- Faculté des sciences et techniques, Laboratoire agroalimentaire et santé, Hassan First University of Settat, Settat, Morocco
| | - Touria Essayagh
- Institut supérieur des sciences de la santé, Laboratoire sciences et technologies de la santé, Hassan First University of Settat, Settat, Morocco
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Abate MW, Nigat AB, Tigabu A, Bantie B, Tiruneh CM, Emiru TD, Tibebu NS, Legas G, Belete A, Walle BG, Feleke MG. Depression and its associated factors among adult hypertensive patients attending follow-up in South Gondar zone public hospitals, Ethiopia, 2023. BMC Psychiatry 2024; 24:360. [PMID: 38745187 PMCID: PMC11094849 DOI: 10.1186/s12888-024-05807-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Depression is the most common public health issue affecting the world's population. Like patients with other chronic medical diseases, hypertensive patients experience many intense emotions which increase their risk for the development of depression. This study aimed to assess the magnitude of depression and its associated factors among hypertensive patients in South Gondar zone governmental hospitals, Northwest Ethiopia, 2023. METHODS An institutional-based cross-sectional study was used in government hospitals of South Gondar Zone. A total of 311 patients were sampled randomly and included in the study. Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Data were analyzed mainly by using descriptive statistics and binary logistics regression. RESULTS A total of 311 patients participated with a 100% response rate. Almost half of the participants were female. The mean age of the respondents was 58.85 years. More than 60% of the respondents had a co-morbid illness. Among participants, 83 (26.7%) of hypertensive patients had depression. Being female, age, uneducated, having poor social support, the presence of co-morbid illness and complications, uncontrolled hypertension, having less than or equal to two dietary regimen and duration of hypertension greater than ten years were significantly associated with depression. CONCLUSION The magnitude of depression was found to be high. This indicated that depression is a common co-morbid illness among hypertensive patients. Healthcare professionals and other stakeholders should consider and diagnose co-morbid diseases like depression among hypertensive patients. It is also better to give particular emphasis to highly vulnerable groups like females, elders, uneducated and those who have poor social support.
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Affiliation(s)
- Moges Wubneh Abate
- Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia.
| | - Adane Birhanu Nigat
- Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Agimasie Tigabu
- Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Chalie Marew Tiruneh
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Tigabu Desie Emiru
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Nigusie Selomon Tibebu
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Getasew Legas
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Belete Gelaw Walle
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Wolayta Sodo University, Wolaita, Ethiopia
| | - Mulualem Gete Feleke
- Department of Adult Health Nursing, College of Health Sciences, Wolayta Sodo University, Wolaita, Ethiopia
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Ai F, Li E, Ji Q, Zhang H. Construction of a machine learning-based risk prediction model for depression in middle-aged and elderly hypertensive people in China: a longitudinal study. Front Psychiatry 2024; 15:1398596. [PMID: 38764471 PMCID: PMC11099225 DOI: 10.3389/fpsyt.2024.1398596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Background Hypertension is a common chronic disease that can trigger symptoms such as anxiety and depression. Therefore, it is essential to predict their risk of depression. The aim of this study is to find the best prediction model and provide effective intervention strategies for health professionals. Methods The study subjects were 2733 middle-aged and older adults who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2018 and 2020. R software was used for Lasso regression analysis to screen the best predictor variables, and logistic regression, random forest and XGBoost models were constructed. Finally, the prediction efficiency of the three models was compared. Results In this study, 18 variables were included, and LASSO regression screened out 10 variables that were important for the establishment of the model. Among the three models, Logistic Regression model showed the best performance in various evaluation indicators. Conclusion The prediction model based on machine learning can accurately assess the likelihood of depression in middle-aged and elderly patients with hypertension in the next three years. And by combining Logistic regression and nomograms, we were able to provide a clear interpretation of personalized risk predictions.
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Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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Amaike C, Salami OF, Bamidele OT, Ojo AM, Otaigbe I, Abiodun O, Adesola O, Adebiyi AO. Association of depression and anxiety with uncontrolled hypertension: A cross-sectional study in Southwest Nigeria. Indian J Psychiatry 2024; 66:157-164. [PMID: 38523755 PMCID: PMC10956585 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_751_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Background Hypertension is a medical condition of public health concern that increases the risk of chronic noncommunicable diseases and mortalities. In recent years, understanding its coexistence with other comorbidities has been the focus of better management. However, the relationship between hypertension and depression or anxiety has been contentious issue, with diverse findings reported by different studies. Understanding this relationship will be crucial for blood pressure control and reducing the mortality associated with hypertension. Therefore, this study was conducted to determine the association between depression or anxiety and hypertension control. Methods A cross-sectional study was conducted among 321 hypertensive patients accessing care in two hospitals. Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). The relationship between blood pressure control and depression or anxiety was assessed using binary logistic regression. Results The prevalence of depression and anxiety was 12.1% and 23.1%, respectively. Up to 261 (81.3%) participants had uncontrolled blood pressure. Of these 261 participants, 14.2% and 23.4% had depression and anxiety, respectively. Depression was associated with an increased risk of uncontrolled blood pressure after adjusting for sex, smoking cigarettes, age, marital status, and exercise (odds ratio (OR) = 7.751, 95% confidence interval (CI) = 1.79-43.4, P = 0.011). Conclusion Depression appears to be independently associated with an increased risk of uncontrolled blood pressure. It is therefore relevant for healthcare providers to assess for depression in patients with hypertension to ensure better hypertensive control.
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Affiliation(s)
- Chikwendu Amaike
- Department of Community Medicine, Babcock University and Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Omotayo F. Salami
- Department of Surgery, Ben Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
- Department of Anesthesia, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | - Olabisi T. Bamidele
- Department of Chemical Pathology, Ben Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Abayomi M. Ojo
- Federal Neuropsychiatric Hospital, Yaba, Lagos State, Nigeria
| | - Idemudia Otaigbe
- Department of Medical Microbiology, School of Basic Clinical Sciences, Benjamin Carson (Snr) College of Health and Medical Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Olumide Abiodun
- Department of Community Medicine, Babcock University and Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
| | | | - Akindele O. Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
- Department of Centre for Research Innovation and Development, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria
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Choong SM, Lee PY, Rashid AA. Prevalence of undiagnosed depression among patients with hypertension: A cross-sectional study of Malaysian primary care perspective. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:10. [PMID: 36992959 PMCID: PMC10042249 DOI: 10.51866/oa.2l4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Introduction This study aimed to determine the prevalence of suspected depression and its associated factors among patients with hypertension in a Malaysian primary care clinic. Method This cross-sectional study was conducted in a primary care clinic from 1 June to 31 August 2019 using the Patient Health Questionnaire-9. Results The prevalence of suspected depression was 9.0%. The significant predictors of depression were Indian ethnicity (adjusted odd ratio [AOR]: 2.373; confidence interval [CI]: 1.147-4.907), divorce (AOR: 3.5; CI: 1.243-9.860), singleness (AOR: 2.241; CI: 1.182-4.251), heavy episodic drinking (AOR: 7.343; CI: 2.494-21.624), low physical activity level (AOR: 1.921; CI: 1.0932.274), low fibre intake (AOR: 1.836; CI: 1.061-3.178), uncontrolled blood pressure (AOR: 1.800; CI: 1.134-2.858) and presence of hypertension complications (AOR: 3.263; CI: 2.053-5.185). Conclusion Primary health care providers must screen for depression among patients with hypertension, particularly those within high-risk groups, and implement interventions that address modifiable risk factors.
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Affiliation(s)
- Siaw Mei Choong
- MD (UPM), MMed Family Medicine (UPM) Klinik Kesihatan Pasir Panjang, Taman Pasir Panjang,Port Dickson, Negeri Sembilan, Malaysia.
| | - Ping Yein Lee
- MBBS (UM), DrFamMed (UM) E-Health Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aneesa Abdul Rashid
- MBBCh BAO (NUI) (IRL), DrFamMed (UKM) Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Abdisa L, Letta S, Nigussie K. Depression and anxiety among people with hypertension on follow-up in Eastern Ethiopia: A multi-center cross-sectional study. Front Psychiatry 2022; 13:853551. [PMID: 36440387 PMCID: PMC9691753 DOI: 10.3389/fpsyt.2022.853551] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background People with hypertension have a high risk of developing mental disorders, such as depression and/or anxiety. However, there is a paucity of data regarding comorbid depression and anxiety symptoms among people with hypertension in study settings. Objective The study determined the prevalence and associated factors of depression, and anxiety symptoms among people with hypertension on follow-up at public hospitals, in Eastern Ethiopia. Materials and methods A cross-sectional study was carried out among 471 people with hypertension who were randomly chosen from four public hospitals in Harar town and the Dire Dawa Administration. The data were collected by interviewer-administered structured questionnaires. A validated nine-item Patient Health Questionnaire and Generalized Anxiety Disorder scales were used to assess depression and anxiety symptoms, respectively. A logistic regression model was used to identify the association among depression, anxiety, and their predictors. An adjusted odds ratio and a 95% confidence interval were used to report the association. The statistical significance was set at a p-value of < 0.05. Results Depression and anxiety symptoms were present in 27.2 and 32.7% of people with hypertension, respectively. Being women (AOR = 1.74, 1.09-2.78), having no formal education (AOR = 2.19, 1.19-4.81), presence of other medical illnesses (AOR = 2.23, 1.39-3.56), having a family history of depression (AOR = 2.01, 1.25-3.19), and poor social support (AOR = 2.80, 1.60-5.22) were statistically associated with depressive symptoms, whereas being women (AOR = 1.54, 1.01-2.35), widowed and divorced (AOR = 2.22, 1.41-3.52), presence of other medical illnesses (AOR = 1.64, 1.06-2.53), and poor social support (AOR = 3.54, 2.09-6.01) were statistically associated with anxiety symptoms. Conclusion More than a quarter of people with hypertension reported symptoms of depression and anxiety. Findings demonstrated that being a woman, having an additional medical illness and having poor social support were statistically associated with depressive and anxiety symptoms. Regular screening, early detection, and offering the proper intervention should be on top priorities for healthcare professionals.
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Affiliation(s)
- Lemesa Abdisa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Shiferaw Letta
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Anxiety and Depression among Hypertensive Adults in Tertiary Care Hospitals of Nepal. PSYCHIATRY JOURNAL 2022; 2022:1098625. [PMID: 35310013 PMCID: PMC8933064 DOI: 10.1155/2022/1098625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/20/2022] [Accepted: 02/22/2022] [Indexed: 12/28/2022]
Abstract
Introduction Cooccurrence of hypertension and depression/anxiety increases the chance of cardiovascular mortality and morbidity. Therefore, this study is aimed at assessing the prevalence of anxiety and depression and their association with hypertension among hypertensive adults in a tertiary care hospital in Kathmandu, Nepal. Methods A descriptive cross-sectional study was conducted using a semistructured self-administered questionnaire based on Hamilton Anxiety and Hamilton Depression Rating Scale. The data was entered in EPI Data and analyzed using descriptive and inferential statistics in SPSS version 22. P value < 0.05 was considered statistically significant. Results A total of 260 individuals participated in the study, with a mean age of 42.6 years. About 46% of patients did not have any symptoms of depressed mood, and 73 (28.1%) of the participants experienced feelings of depressed mood only on questioning. Similarly, (151) 58.1% did not have feelings of guilt, and 48 (18.5%) participants who had the feeling of guilt had let people down. Among 260 respondents, most participants ((102) 39.2%) had mild symptoms of anxious mood, followed by (86) 33.1% participants with moderate symptoms. Only (4) 1.5% of participants had severe symptoms. Similarly, the majority of participants ((114) 43.8%) had a mild form of mental and emotional strain, followed by (72) 27.7% with moderate mental and emotional strain while (43) 16.5% had no mental and emotional strain. The occupation and marital status of the hypertensive individual was associated with anxiety and depression (P = ≤0.01). Conclusion In conclusion, anxiety and depression were common among patients with hypertension. Anxiety and depression were linked to some of the patients' sociodemographic and clinical features. This study demonstrates that treating hypertension alone is not enough to improve patients' quality of life; mental illness screening among chronically ill individuals is also required.
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Psychological Backgrounds of Medically Compromised Patients and Its Implication in Dentistry: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168792. [PMID: 34444548 PMCID: PMC8392062 DOI: 10.3390/ijerph18168792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
The number of medically compromised dental patients is increasing every year with the increase in the super-aged population. Many of these patients have underlying psychiatric problems and diseases, which need to be recognized by dental professionals for better treatment outcomes. The aim of this narrative review article is to summarize the psychological and psychiatric backgrounds of medically compromised patients who are frequently visited and taken care of by dentists using findings from recent systematic reviews and meta-analyses. Anxiety and symptoms of depression, post-traumatic stress disorders, panic disorders, poor cognitive functions, and poor quality of life were some of the common psychological backgrounds in medically compromised patients. Additionally, the consequences of these psychological problems and the considerations that need to be taken by the dentist while treating these patients have been discussed. Dental professionals should be aware of and recognize the different psychological backgrounds of medically compromised dental patients in order to provide appropriate dental treatment and to prevent oral conditions from worsening.
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Albasara SA, Haneef MS, Zafar M, Moinuddin KG. Depression and associated risk factors among hypertensive patients in primary health care centers in Dammam, Kingdom of Saudi Arabia. Pan Afr Med J 2021; 38:278. [PMID: 34122705 PMCID: PMC8179995 DOI: 10.11604/pamj.2021.38.278.27133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/01/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction depression is a common mental illness and Hypertension is a chronic disease and due to the negligence depression is co-morbidity with hypertension. The aim of this study was to determine the prevalence of depression and its associated factor among hypertensive patients in Dammam. Methods it was a cross-sectional study and 342 hypertensive patients were selected from primary health care centers in Dammam, KSA. Beck Depression Inventory scale was used to determine the depression. The logistic regression analysis was used to assess the correlation between depression (dependent) and other variables. The P-value of less than 0.05 has been set to be statistically significant. Results the proportion of depression with various degrees of severity among study participants was 19.6%. After Adjustment of covariates, older age [aOR 3.33, 95% CI 1.22-9.10; p= 0.019,low income [a OR 3.19, 95% CI 1.02-9.11; p= 0.003, illiterate [aOR 3.41, 95% CI 1.09-7.65; p= 0.005], physical inactivity [aOR 2.65, 95% CI 1.21-9.65; p= 0.051], ever smoker [aOR 2.99, 95% CI 1.09-3.77; p= 0.002], long standing hypertension > 3 years [aOR 3.765, 95% CI 1.01-7.10; p= 0.049] were more likely significantly associated with depression among hypertensive patients. Conclusion depression is common among hypertensive patients in our setting. The associated multiple risk factors are older age, low income (< 3000 SR), physical inactivity, long standing hypertension.
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Affiliation(s)
- Sumood Abdulbaqi Albasara
- Department of Public Health, College of Public Health, Imamm Abdul Rehman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Shafee Haneef
- Department of Public Health, College of Public Health, Imamm Abdul Rehman Bin Faisal University, Dammam, Saudi Arabia
| | - Mubashir Zafar
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, Saudi Arabia
| | - Khawaja Ghulam Moinuddin
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, Saudi Arabia
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Khadoura KJ, Shakibazadeh E, Mansournia MA, Aljeesh Y, Fotouhi A. Undiagnosed Depression among Hypertensive Individuals in Gaza: A Cross-sectional Survey from Palestine. Ethiop J Health Sci 2021; 31:339-348. [PMID: 34158786 PMCID: PMC8188075 DOI: 10.4314/ejhs.v31i2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/15/2020] [Indexed: 11/17/2022] Open
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 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. Generalized 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-adherence 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 positively associated with BDI-II score. On the other hand, 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 the care of HTNP in PHCC.
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Affiliation(s)
- Khalid Jamal Khadoura
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences-International Campus, Tehran, Iran
- Department of Nursing, Faculty of Medical Sciences, Israa University-Gaza, Palestine
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Aljeesh
- Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Endomba FT, Mazou TN, Bigna JJ. Epidemiology of depressive disorders in people living with hypertension in Africa: a systematic review and meta-analysis. BMJ Open 2020; 10:e037975. [PMID: 33303433 PMCID: PMC7733170 DOI: 10.1136/bmjopen-2020-037975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Better knowledge of epidemiology of depressive disorders in people living with hypertension can help to implement pertinent strategies to address its burden. The objective was to estimate the prevalence of depressive disorders and symptoms in people living with hypertension in Africa. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, EMBASE, African Index Medicus, African Journals OnLine were searched up to 31 January 2020, regardless of the language of publication. ELIGIBILITY CRITERIA We included studies conducted among adult patients with hypertension (≥18 years) living in Africa and reporting the prevalence of depressive disorders and symptoms. DATA EXTRACTION AND SYNTHESIS Two independent investigators selected studies, extracted data and assessed the methodological quality of included studies by using the tools developed by Joanna Briggs Institute. Multivariate random-effects meta-analysis served to pool data by considering the variability between diagnostic tools used to identify patients with depressive disorders or symptoms. RESULTS We included 11 studies with 5299 adults with hypertension. Data were collected between 2002 and 2017, from South Africa, Nigeria, Ghana, Ethiopia and Burkina Faso. The mean age varied between 50.3 years and 59.6 years. The proportion of men ranged from 28% to 54%. The adjusted prevalence of depressive disorders taking into account the variance between diagnostic tools was 17.9% (95% CI 13.0% to 23.4%). The prevalence of depressive symptoms and major depressive symptoms was 33.3% (95% CI 9.9% to 61.6%) and 7.8% (95% CI 3.0% to 14.5%), respectively. There was heterogeneity attributable to the diagnostic tools for depressive disorders and symptoms. There was no publication bias. CONCLUSION Notwithstanding the representativeness lack of some (sub) regions of Africa, weakening the generalisability of findings to the entire region; depressive disorders and symptoms are prevalent in people living with hypertension in Africa, indicating that strategies from clinicians, researchers and public health makers are needed to reduce its burden in the region.
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Affiliation(s)
- Francky Teddy Endomba
- Health Economics and Policy Research and Evaluation for Development Results Group, Yaounde, Cameroon
- Psychiatry Internship Program, Université de Bourgogne, Dijon, Bourgogne, France
| | - Temgoua Ngou Mazou
- Health Economics and Policy Research and Evaluation for Development Results Group, Yaounde, Cameroon
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaounde, Cameroon
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Boima V, Tetteh J, Yorke E, Archampong T, Mensah G, Biritwum R, Yawson AE. Older adults with hypertension have increased risk of depression compared to their younger counterparts: Evidence from the World Health Organization study of Global Ageing and Adult Health Wave 2 in Ghana. J Affect Disord 2020; 277:329-336. [PMID: 32858314 DOI: 10.1016/j.jad.2020.08.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Depression and hypertension interact through a complex interplay of social, behavioral and biological factors. Despite the huge burden of hypertension in the African sub-region, very little information exists on depression among hypertensive patients. This study assessed the prevalence and factors associated with depression among young and older adult hypertensive patients in Ghana. METHOD Data from the World Health Organization Study on Global AGEing and Adult Health wave 2 (2014/2015) for Ghana was used. Depression was estimated among participants with blood pressure 140/90mmHg and above. Weighted descriptive statistics and logistic regression with adjusted predictions were carried out. The analysis was performed using Stata 15. RESULT The overall prevalence of depression was 6.3%. Older hypertensive patients had almost twice the prevalence of depression compared with younger patients (8.4% vs 4.5%). The factors which predicted depression among hypertensive patients were educational level, marital status, religion, region of residence, work status, self-rated health (SRH), and unhealthy lifestyle. Participants with no religion were more than 7 times likely to be depressed compared with Christians [aOR(95%CI)=7.52(2.11-26.8)]. Those in the Volta region were more than 8 times likely to be depressed compared to those in the Greater Accra region [aOR(95%CI)=8.58(2.51-29.3)]. CONCLUSION Older adult hypertensive patients were more likely to experience depressive symptoms. Multiple factors predicted depression in both young and old hypertensive patients; thus a comprehensive care package including psychological support for patients with hypertension is essential for optimum clinical management.
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Affiliation(s)
- Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - John Tetteh
- Department of Community Health, School of Public Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Ernest Yorke
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Timothy Archampong
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - George Mensah
- Department of Community Health, School of Public Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Richard Biritwum
- Department of Community Health, School of Public Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, School of Public Health, University of Ghana Medical School, University of Ghana, Accra, Ghana.
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13
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Li H, Xia H, Yi S, Rao L. Social capital, depressive symptoms, and perceived quality of care among hypertensive patients in primary care. Health Qual Life Outcomes 2020; 18:378. [PMID: 33261641 PMCID: PMC7709396 DOI: 10.1186/s12955-020-01630-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
Background Depression is an important issue in the management of hypertension. However, little attention has been paid to addressing such aspects of psychological health among patients with hypertension. We aimed to estimate the prevalence of depressive symptoms among patients with hypertension in primary care settings and to identify the potential role of social capital in predicting depressive symptoms. The influence of psychological well-being on the perceived quality of hypertensive care was also examined. Methods In Shenzhen, China, an on-site cross-sectional study was conducted from March to September 2017. In total, 1046 respondents completed a face-to-face survey interview. We examined the associations between social capital, depressive symptoms, and perceived quality of care. Results The results showed that 10.7% of patients with hypertension who attended primary care facilities had depressive symptoms. Two components of social capital—social ties (9.63 vs. 10.67; OR = 1.314, 95% CI 1.165–1.483; P < .001) and trust (3.46 vs. 3.89; OR = 2.535, 95% CI 1.741–3.691; P < .001)—were protective factors for depression among patients with hypertension in primary care settings. We also found that depressive symptoms were negatively associated with perceived quality of care (30.5 vs. 32.5; β = 1.341, 95% CI 0.463–2.219; P = .003).. Conclusions We found inverse associations between depressive symptoms and perceived quality of care and between social capital and the occurrence of symptoms of depression. Our findings suggest that strategies addressing both hypertension and depressive symptoms should be implemented to better manage hypertension. Appropriate social interventions should be designed and implemented.
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Affiliation(s)
- Haitao Li
- Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Xueyuan AVE 1098, Nanshan District, Shenzhen, China.
| | - Hui Xia
- Center for Chronic Diseases Prevention and Control, Longhua District, Shenzhen, China
| | - Shijian Yi
- Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Xueyuan AVE 1098, Nanshan District, Shenzhen, China
| | - Lichang Rao
- Hebei Research Institute for Human Resources and Social Security Science, Hebei, China
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Zhang B, Zhang W, Sun X, Ge J, Liu D. Physical Comorbidity and Health Literacy Mediate the Relationship Between Social Support and Depression Among Patients With Hypertension. Front Public Health 2020; 8:304. [PMID: 32850572 PMCID: PMC7419472 DOI: 10.3389/fpubh.2020.00304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/04/2020] [Indexed: 02/05/2023] Open
Abstract
Depression is a common comorbidity among patients with hypertension. Patients with hypertension and depression have worse health outcomes compared to those without depression. The combined effects of social support, physical comorbidity, and health literacy on depression among individuals with hypertension remain unclear. A survey was conducted between December 2017 and May 2018 to investigate the relationships among social support, physical comorbidity, health literacy, and depression in a population of patients with hypertension in rural areas of Sichuan province, China. Multiple linear regression was used to examine factors that influenced depression, and structural equation modeling (SEM) was used to examine the relationships among the four study variables. The mean scores of 549 patients with hypertension were 37.17 ± 6.84 for social support, 14.62 ± 6.26 for health literacy, and 3.56 ± 3.05 for depression; furthermore, 34.2% of participants had physical comorbidity. Gender and per capita annual family income were significantly associated with depression. Physical comorbidity was directly positively related to depression while health literacy was directly negatively related to depression. Social support had an indirect negative association with depression by the mediating effects of health literacy and physical comorbidity. Adequate social support and health literacy, and less physical comorbidity could potentially contribute to reducing depression. The study highlights the importance of social support in maintaining mental health among patients with hypertension. Strategies that target the enhancement of social support and health literacy should be prioritized to relieve depression among patients with hypertension. More attention should be paid to women, low-income individuals, and patients with physical comorbidities.
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Affiliation(s)
- Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wenjie Zhang
- The Department of Academic Affairs, West China School of Medicine/ West China Hospital, Sichuan University, Chengdu, China
| | - Xiaxia Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jingjing Ge
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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15
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Gebre BB, Deribe B, Abeto M. Magnitude and Associated Factors of Depression Among Hypertensive Patients Attending Treatment Follow Up in Chronic OPD at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. Integr Blood Press Control 2020; 13:31-39. [PMID: 32273751 PMCID: PMC7106993 DOI: 10.2147/ibpc.s240015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Hypertension and depression are among the most common public health issues affecting the population around the world. Like patients with other chronic medical conditions, hypertensive patients experience many intense emotions which increase their risk for the development of depression. Globally, depression is the leading cause of disability and 382 million people suffer worldwide. Objective The aim of this study was to assess the magnitude and factors associated with depression among hypertensive patients attending treatment follow up in the chronic OPD at Hawassa University Comprehensive Specialized Hospital (HUCSH) from March to May, 2019. Methods An institutional-based cross-sectional study was conducted with 310 hypertensive patients attending treatment follow up at the chronic Out-Patient Department of HUCSH at Hawassa from March to May, 2019. A validated patient health questionnaire (PHQ−9) was used to assess depression. The data were entered using EPI-data version 3.1 and analyzed in SPSS version 22. Binary logistic regression was used to determine the association of independent variables with dependent variables. Results The magnitude of depression among hypertension (HPN) patients was found to be 73 (24.7%). The independent predictors were sex 2.6 (1.16, 5.83), age 11.2 (2.98, 42), educational status, social support 2.55 (1.09, 5.94), family history of depression 7.12 (1.48, 34.26), hypertension 7.57 (2.67, 21.44), and medication adherence 11.6 (4.23, 31.78). Conclusion The magnitude of depression among HPN patients was high. So, continuous health information dissemination at a different level regarding factors affecting them should be given. Strengthening a referral linkage with a psychiatric unit for psycho-behavioral therapy will bring good clinical outcome. Besides, controlling hypertension was crucial to bring good clinical outcome.
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Affiliation(s)
- Bereket Beyene Gebre
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Mintesnot Abeto
- College of Health Science, Hawassa University, Hawassa, Ethiopia
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Raghuraman P, Balasundaram S, Sarkar S, Subramaniam E. A cross-sectional study of psychiatric morbidity and quality of life among participants utilizing the preventive health-care services of a tertiary hospital. Indian J Psychiatry 2019; 61:192-197. [PMID: 30992615 PMCID: PMC6425810 DOI: 10.4103/psychiatry.indianjpsychiatry_159_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The burden of mental disorders has been increasingly recognized and 450 million people globally are suffering from mental illness. Mental-physical comorbidity has adverse effects on the overall outcome. Research is scarce with regard to mental health screening in the context of "preventive health care" in India. Thus, the study aimed to identify the prevalence of mental illness and the effect on quality of life (QOL) among participants attending preventive health-care unit (PHCU). SETTINGS AND DESIGN This was a cross-sectional study conducted in PHCU of a tertiary hospital in Puducherry. MATERIALS AND METHODS All consecutive participants (>18 years) attending PHCU were included in the study. The Standard for Clinicians' Interview in Psychiatry (SCIP) screening module, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 1 Cross-Cutting Symptom Measure, Mini-Cog, and Quality of Life Enjoyment and Satisfaction Questionnaire were administered. Relevant diagnostic modules of SCIP were applied to participants who screened positive on SCIP. Data analysis was performed using SPSS (version 17.0). RESULTS The mean age of participants was 43.38 ± 13.99 years. Of 203 participants enrolled, 28.1% screened positive and 26.1% were confirmed to have psychiatric disorder. About 4% screened positive for cognitive impairment. Most commonly diagnosed disorders were alcohol use disorder and major depressive disorder. The prevalence of depressive disorder was higher in patients with physical disorder. Participants with psychiatric disorder alone or with both psychiatric and physical disorders had significantly poorer QOL (F = 27.13; P < 0.001). CONCLUSION One-fourth of the participants attending preventive health-care services were found to have psychiatric disorders. The presence of psychiatric disorder was associated with significantly poorer QOL. This highlights the importance of routine mental health screening in this setting.
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Affiliation(s)
- Preethy Raghuraman
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sivaprakash Balasundaram
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Sukanto Sarkar
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Eswaran Subramaniam
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Anxiety and Depression among Hypertensive Outpatients in Afghanistan: A Cross-Sectional Study in Andkhoy City. Int J Hypertens 2018; 2018:8560835. [PMID: 30155287 PMCID: PMC6093076 DOI: 10.1155/2018/8560835] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/07/2018] [Accepted: 07/16/2018] [Indexed: 11/18/2022] Open
Abstract
There is a relationship between mental and physical health. Depression and anxiety are linked with the development of several chronic diseases. The purpose of the present study was to determine the prevalence and factors associated with anxiety and depression among adult hypertensive outpatients in Afghanistan. Methods. Two hundred thirty-four consecutive hypertensive patients from December 2015 to August 2016 were recruited to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire, which has scores for classifying the participants having anxiety and depression symptoms. Results. Of the total 234 patients, 81 (34.6%) were males and 153 (65.4%) were females. The mean age was 54.6 ± 12.7 for the hypertensive patients with anxiety and 63.8 ± 15.0 for the hypertensive patients with depression while this figure was 49.5 ± 10.2 for the adult participants in general population in Kabul city (Saeed, 2013). The prevalence of anxiety and depression (42.3% vs. 58.1%) among hypertensive persons is compared with the same mental disorders among Afghan refugees (39.3% vs. 22.1%) in Dalakee Refugee Camp (in Iran) (Hosseini Divkolaye and Burkle, 2017). Of the total participants, 99 had anxiety (42.3%), 136 had depression (58.1%), and 66 had (28.2%) comorbid anxiety-depression. Multivariate analysis was used. For anxiety age, female gender, smoking, diabetes mellitus, and 2 or more chronic diseases had a significant association. For depression, age and diabetes mellitus had a significant association, and for comorbid anxiety, depression, age, diabetes mellitus, and 2 or more chronic diseases had a significant association. Conclusion. This study shows that anxiety and depression are highly prevalent among hypertensive patients in an outpatient clinic in Afghanistan. There was an association between some sociodemographic and clinical characteristics and anxiety and depression. More studies are needed on a national level to inform the development of strategies for the prevention and control of psychological distress among patients with chronic diseases in Afghanistan.
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Abstract
Hypertension and depression, as 2 major public health issues, are closely related. For patients having hypertension, in particular, depression is a risk factor for mortality and jeopardizes their wellbeing. The aim of the study is to apply support vector machine (SVM) learning to blood tests and vital signs to classify patients having hypertension complicated by depression and patients having hypertension alone for the identification of novel markers.Data on patients having both hypertension and depression (n = 147) and patients having hypertension alone (n = 147) were obtained from electronic medical records of admissions containing the records on blood tests and vital signs. Using SVM, we distinguished patients having both hypertension and depression from gender- and age-matched patients having hypertension alone.SVM-based classification achieved 73.5% accuracy by 10-fold cross-validation between patients having both hypertension and depression and those having hypertension alone. Twelve features were selected to compose the optimal feature sets, including body temperature (T), glucose (GLU), creatine kinase (CK), albumin (ALB), hydroxybutyrate dehydrogenase (HBDH), blood urea nitrogen (BUN), uric Acid (UA), creatinine (Crea), cholesterol (TC), total protein (TP), pulse (P), and respiration (R).SVM can be used to distinguish patients having both hypertension and depression from those having hypertension alone. A significant association was identified between depression and blood tests and vital signs. This approach can be helpful for clinical diagnosis of depression, but further studies are needed to verify the role of these candidate markers for depression diagnosis.
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Affiliation(s)
- Xiuli Song
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University Web Sciences Center Big Data Research Center, University of Electronic Science and Technology of China Information Center, West China Hospital, Sichuan University College of Foreign Languages and Cultures, Sichuan University, Chengdu, PR China
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