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慢性病中抑郁和焦虑的发生率及预测因素:一项涵盖非传染性疾病和传染性疾病的多病种研究

Frequency and predictors of depression and anxiety in chronic illnesses: A multi disease study across non-communicable and communicable diseases.

作者信息

Abbas Uzair, Hussain Niaz, Tanveer Misha, Laghari Rabeel Nawaz, Ahmed Ishfaque, Rajper Ali Bux

机构信息

Department of Physiology, Dow University of Health Sciences, Karachi, Pakistan.

Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.

出版信息

PLoS One. 2025 May 7;20(5):e0323126. doi: 10.1371/journal.pone.0323126. eCollection 2025.

Abstract

BACKGROUND

Depression and anxiety are among the most common mental health conditions globally that impact the lifestyle of affected individuals. Mental conditions and chronic diseases are linked to each other bidirectionally. Depression and anxiety with comorbid chronic conditions are often neglected or under-screened and possess challenges in treatment. This study aimed to know the frequency and determinants of depression and anxiety along with the severity level among common chronic communicable and non-communicable diseases.

METHODS

We enrolled 200 healthy controls and 800 cases with equal number (n = 400) of patients with communicable and non-communicable diseases. Depression and anxiety were screened through Hamilton's rating scale for depression and anxiety separately. We also measured the determinants of severe depression among patients with chronic diseases. Data was analyzed through SPSS version 23.

RESULTS

We found higher frequency of depression (31% vs 11%; p=<0.001) and anxiety (13.25% vs 6%; p = 0.021) among cases as compared to healthy controls respectively. We found higher levels of depression among participants with non-communicable diseases as compared to communicable diseases (37.25% vs 24.75%; p < 0.05) respectively. Moreover, there was a higher frequency of anxiety in participants with communicable diseases as compared to those with non-communicable diseases, but the difference was non-significant (14% vs 12.5% p = 0.081). Among non-communicable diseases the highest percentage was found among individuals with cancer (67%), followed by diabetes (38%), cardiovascular diseases (33%) and respiratory disorders (11%). Among participants with communicable diseases, the highest percentage of depression was found in patients with Tuberculosis (29%) followed by HIV/AIDS (28%), Long COVID-19 (25%) and Hepatitis B/C (17%).

CONCLUSION

There is a significantly higher percentage of depression and anxiety among participants with chronic diseases. It calls for a comprehensive approach to patient care that incorporates mental health as a fundamental aspect of the treatment and management of chronic diseases. Understanding the predictors of severe depression across different chronic conditions helps in stratifying patients who may benefit most from integrated psychiatric and psychological interventions.

摘要

背景

抑郁症和焦虑症是全球最常见的心理健康问题,会影响患者的生活方式。心理状况与慢性病相互关联。伴有慢性疾病的抑郁症和焦虑症往往被忽视或筛查不足,治疗也面临挑战。本研究旨在了解常见慢性传染病和非传染病中抑郁症和焦虑症的发生率、决定因素以及严重程度。

方法

我们招募了200名健康对照者和800例患者,其中传染病和非传染病患者各400例。分别通过汉密尔顿抑郁量表和焦虑量表对抑郁症和焦虑症进行筛查。我们还测量了慢性病患者中重度抑郁症的决定因素。数据通过SPSS 23版进行分析。

结果

我们发现,与健康对照者相比,病例组中抑郁症(31%对11%;p<0.001)和焦虑症(13.25%对6%;p = 0.021)的发生率更高。我们发现,与传染病患者相比,非传染病患者中的抑郁症水平更高(37.25%对24.75%;p < 0.05)。此外,与非传染病患者相比,传染病患者中的焦虑症发生率更高,但差异不显著(14%对12.5%,p = 0.081)。在非传染病中,癌症患者的比例最高(67%),其次是糖尿病(38%)、心血管疾病(33%)和呼吸系统疾病(11%)。在传染病患者中,抑郁症比例最高的是结核病患者(29%),其次是艾滋病毒/艾滋病患者(28%)、长期新冠患者(25%)和乙肝/丙肝患者(17%)。

结论

慢性病患者中抑郁症和焦虑症的比例显著更高。这需要一种全面的患者护理方法,将心理健康作为慢性病治疗和管理的基本方面。了解不同慢性病中重度抑郁症的预测因素有助于对可能从综合精神科和心理干预中获益最大的患者进行分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b77/12057975/d5d60cfa54f7/pone.0323126.g001.jpg

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