Depression and anxiety among persons with type II diabetes mellitus and hypertension; A cross-sectional analytical study in the rural field practice area of a tertiary care center in Puducherry

Abstract

Objectives: To determine the proportion of depression and anxiety disorders; their association with sociodemographic, NCD-related factors and Quality of Life among persons with type II Diabetes Mellitus or Hypertension at a rural health center in Puducherry. Materials and Methods: This facility-based cross-sectional analytical study recruited 692 participants from May 2020 to September 2021. A structured questionnaire collected sociodemographic and NCD-related history; The Hospital Anxiety and Depression Scale (HADS) and The World Health Organization quality of life (WHOQOL) - BREF questionnaires for depression, anxiety and QOL assessment, respectively. Independent variables were assessed for relationship with depression and anxiety using univariate analysis. Multivariable logistic regression analysis was done to determine the predictors of depression and anxiety. Results: Nearly 17.8% (95% confidence interval [CI] - 13.8%–22.4%) had depression and 12.7% (95% CI - 9.5–16.7%) had anxiety. Age (adjusted odds ratio [aOR] - 0.97; 95% CI - 0.95–0.99), depression/anxiety disorders family history (aOR - 2.58; 95% CI - 1.26–5.26), overall QOL score reduction (aOR - 0.76; 95% CI - 0.60–0.97), and social domain score reduction (aOR - 0.98; 95% CI - 0.97–0.99) were the significant predictors of depression. No formal education (aOR - 10.84; 95% CI - 4.54–25.86), being homemaker (aOR - 3.49; 95% CI - 1.29–9.42), no DM/HTN family history (aOR - 1.51; 95% CI - 0.66–1.54), psychological domain score reduction (aOR - 0.97; 95% CI - 0.95–0.99) and environmental domain score reduction (aOR - 0.96; 95% CI - 0.94–0.98) were significant predictors of anxiety. Conclusion: Nearly one-fifth had depression and more than one-tenth had anxiety among the participants. A fair number of persons with HTN/DM have higher anxiety and depressive scores and most domains had a poor QOL score with depression alone having associated with a depression/anxiety family history.