King Saud University, Riyadh, Saudi Arabia.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211054987. doi: 10.1177/21501327211054987.
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.
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.
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], -value = .03 and OR 4.65 [95% CI 1.63,13.22], -value <.03, respectively) and dyslipidemia (OR 5.93 [95% CI 1.54, 22.86], -value = .01, and OR 4.70 [95% CI 0.78, 28.35], -value = .09, respectively). The odds of developing depression were 4 times higher (-value .04) in patients with rheumatoid arthritis.
Among patients attending primary care outpatient clinics, anxiety, and depression were significantly associated with type 2 diabetes and rheumatoid arthritis, respectively. Social determinants and lifestyle factors play a major role in the development of common chronic diseases in Saudi Arabia. Primary care physicians should consider the patients' psychological status, sociodemographic status, and lifestyle risks during the management of chronic diseases.
慢性病患者可能会经历心理状况，包括焦虑和抑郁。然而，慢性病与这些心理状况之间的关系尚不清楚。本研究旨在确定焦虑、抑郁与常见慢性病（高血压、2 型糖尿病、血脂异常和类风湿关节炎）之间的关系，并在初级保健门诊环境中研究其与社会决定因素的关系。
对符合条件的参与者进行电子方式的医院焦虑和抑郁量表评估。对于每种情况（焦虑和抑郁），根据他们 21 分的得分（≤7 分为正常，8-10 分为边缘异常，≥11 分为异常）将参与者分为正常、边缘异常和异常。分析和比较了每个类别的分数和参与者人数，以及他们的人口统计学特征和慢性病，以确定关联和关系。
我们招募了 271 名（平均年龄 51.65 ± 11.71 岁）在初级保健诊所就诊的患者。其中，17.7%和 8.9%的患者分别有边缘异常和异常抑郁，10.3%和 8.9%的患者有边缘异常焦虑和异常焦虑。检查了常见的社会决定因素和生活方式因素。年龄、性别和含糖饮料的摄入显著增加了高血压和 2 型糖尿病的发病风险；每周剧烈运动 3 次可降低患这些慢性病的几率。调整后的回归模型显示，医院焦虑和抑郁量表的边缘和异常焦虑评分与 2 型糖尿病（比值比 [OR] 3.04 [95%置信区间 1.13,8.19]，-值 =.03）和血脂异常（OR 4.65 [95%置信区间 1.63,13.22]，-值 <.03）的存在之间存在统计学显著关联。患 2 型糖尿病的几率（-值 =.04）高出 4 倍。患血脂异常的几率（OR 5.93 [95%置信区间 1.54,22.86]，-值 =.01）和异常焦虑（OR 4.70 [95%置信区间 0.78,28.35]，-值 =.09）。类风湿关节炎患者患抑郁症的几率高出 4 倍（-值 =.04）。
在初级保健门诊就诊的患者中，焦虑和抑郁与 2 型糖尿病和类风湿关节炎显著相关。社会决定因素和生活方式因素在沙特阿拉伯常见慢性病的发展中起主要作用。初级保健医生在管理慢性病时应考虑患者的心理状态、社会人口统计学状况和生活方式风险。
