Correlates of disability among primary care patients with common mental disorders and chronic medical conditions- a cross-sectional study from rural South India

Abstract

Abstract Purpose We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India. Methods The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations. Results The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability. Conclusion Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability. Trial registration ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.