Ojha Ramesh, Adhikari Chiranjivi, Kaphle Hari Prasad, Adhikari Dikshya
School of Health and Allied Sciences, Pokhara University, Kaski, Nepal.
PLoS One. 2025 May 30;20(5):e0321436. doi: 10.1371/journal.pone.0321436. eCollection 2025.
Cardiovascular diseases (CVDs) are the leading global cause of death, whereas mental disorders account for one-third of all global disabilities. Despite clear available evidence of a significant relationship between the CVDs and mental disorders, and the CVDs being regressional to certain risk factors, they are less explored in the Nepalese context, especially for mental disorders. Hence, we aimed to determine the prevalence of mental health status and its associated factors among people with cardiovascular risk status.
A community-based study was carried out during Sep-Nov 2024 among 390 people aged 30-69 years with cardiovascular risk status in Godawari Municipality, Kailali. Data were collected with face-to-face interviews using structured questionnaires consisting of four sections: a) socio-demographic characteristics; b) CVD risk factors; c) mental health status; and d) anthropometric measurements, using the KoboToolbox, a mobile and computer-based application. Further, we imported data into SPSS software for statistical analysis. We presented categorical variables as frequency and percentage and continuous variables as median and quartiles. We applied univariate and multivariate logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), beta coefficients (β), their 95% confidence interval, and p-values.
Of 390 participants, females were two-thirds (67%), and the median age was 48 (36 ~ 60). The prevalences of depression, anxiety, and stress symptoms were found to be 47.2%, 62.3% and 55.1%, respectively. From multivariate logistic regression analysis, depression symptoms were positively associated with females (β = 1.002, p < .001) and the presence of one CVD risk factor (β = 1.082, p = .016), two risk factors (β = 1.362, p = .006) and three or more risk factors (β = 1.720, p = .017). Anxiety symptoms were associated with exposure to secondhand smoking (β = 0.725, p = .024) and the presence of one risk factor (β = 1.548, p < .001), two risk factors (β = 1.734, p < .001) and three or more risk factors (β = 1.852, p = .022). Dalit, Janajati and Madhesi (β = 0.735, p = .026) and the presence of one risk factor (β = 1.811, p = .001), two risk factors (β = 2.054, p = .016) and three or more risk factors (β = 2.138, p < .001) were associated with stress symptoms. All three mental disorders were found to worsen as the number of CVD risk factors increased.
The study revealed that nearly fifty percent of the prevalence of each of depression, anxiety, and stress symptoms among people with cardiovascular risk status. Mental health screening is suggested among the people with CVD risk factors, additionally considering female, secondhand smoker, and disadvantaged ethnic populations for depression, anxiety, and stress, respectively. Further, a validation study is recommended for accuracy and yield.
心血管疾病（CVDs）是全球主要的死亡原因，而精神障碍占全球所有残疾的三分之一。尽管有明确的证据表明心血管疾病与精神障碍之间存在显著关系，并且心血管疾病与某些风险因素相关，但在尼泊尔的背景下，对它们的研究较少，尤其是关于精神障碍方面。因此，我们旨在确定心血管疾病风险人群的心理健康状况及其相关因素的患病率。
2024年9月至11月期间，在凯拉利戈达瓦里市对390名年龄在30 - 69岁且有心血管疾病风险的人群进行了一项基于社区的研究。使用由四个部分组成的结构化问卷通过面对面访谈收集数据：a）社会人口学特征；b）心血管疾病风险因素；c）心理健康状况；d）人体测量数据，使用基于移动和计算机的应用程序KoboToolbox。此外，我们将数据导入SPSS软件进行统计分析。我们将分类变量表示为频率和百分比，将连续变量表示为中位数和四分位数。我们应用单变量和多变量逻辑回归来确定与抑郁症状、焦虑和压力相关的因素。逻辑回归的结果表示为粗比值比、调整后的比值比（AOR）、β系数（β）、它们的95%置信区间和p值。
在390名参与者中，女性占三分之二（67%），年龄中位数为48岁（36至60岁）。抑郁、焦虑和压力症状的患病率分别为47.2%、62.3%和55.1%。从多变量逻辑回归分析来看，抑郁症状与女性（β = 1.002，p <.001）以及存在一种心血管疾病风险因素（β = 1.082，p =.016）、两种风险因素（β = 1.362，p =.006）和三种或更多风险因素（β = 1.720，p =.017）呈正相关。焦虑症状与接触二手烟（β = 0.725，p =.024）以及存在一种风险因素（β = 1.548，p <.001）、两种风险因素（β = 1.734，p <.001）和三种或更多风险因素（β = 1.852，p =.022）有关。达利特、贾纳贾蒂和马德西族（β = 0.735，p =.026）以及存在一种风险因素（β = 1.811，p =.001）、两种风险因素（β = 2.054，p =.0
