Chakravartty Meghna, Shuvo Md Mashuk Shahriar, Kumari Sita, Jhilik Tanni Chakma, Sarker Tanmoy, Akter Fahmida, Hossain Md Mokbul, Ahsan Ali, Latif Mahbub, Mridha Malay Kanti
Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Bangladesh.
Statistical Research and Training, Dhaka University, Dhaka, Bangladesh.
BMJ Open. 2025 Sep 5;15(9):e102000. doi: 10.1136/bmjopen-2025-102000.
The rising burden of non-communicable diseases (NCDs), including mental health disorders (MHDs) such as anxiety and depression, poses a significant public health challenge globally. Evidence suggests that both diabetes and hypertension, the two most prevalent NCDs, are linked to a higher prevalence of MHDs. However, there is a lack of evidence on prevalence of generalised anxiety disorder (GAD) and depression among adults living with both diabetes and hypertension in Bangladesh. We aimed to assess the prevalence of GAD and depression and explore the associated factors among adults living with diabetes and hypertension comorbidity in rural Bangladesh.
We implemented a cross-sectional study.
The study was conducted in Chirirbandar, a sub-district of Dinajpur, Bangladesh.
We interviewed a total of 387 adults living with diabetes and hypertension comorbidity.
We had two primary outcome measures: GAD and depression. Individuals scoring ≥10 on the General Anxiety Disorder-7 scale were considered as having GAD and individuals scoring ≥10 on the Patient Health Questionnaire-9 scale were considered as having depression. The outcome variables were dichotomised based on these scores.
The prevalence of GAD was 7.24% (95% CI 5.04 to 10.29). Education level (grades 5-9) (adjusted OR (AOR): 3.40, 95% CI 1.26 to 9.19) and household wealth status (highest wealth tertile) (AOR: 0.12, 95% CI 0.02 to 0.62) were associated with GAD. The prevalence of depression was 17.83% (95% CI 14.32 to 21.98). Socioeconomic factors associated with depression included unemployment (AOR: 3.26, 95% CI 1.05 to 10.10) and household wealth status (highest wealth tertile) (AOR: 0.45, 95% CI 0.21 to 0.98). Higher odds of depression were also observed among participants with controlled hypertension (AOR: 3.88, 95% CI 1.81 to 8.35). Other factors, such as tobacco use, dietary diversity and physical activity, were not associated with GAD or depression.
A high prevalence of GAD and depression was observed among adults living with diabetes and hypertension comorbidity. The findings from the study emphasise the need for integration of mental health services into the existing non-communicable disease care. The identified factors associated with GAD or depression should be considered to develop targeted interventions for people with hypertension and diabetes comorbidity in Bangladesh.
包括焦虑和抑郁等精神健康障碍（MHDs）在内的非传染性疾病（NCDs）负担不断加重，在全球范围内构成了重大的公共卫生挑战。有证据表明，糖尿病和高血压这两种最常见的非传染性疾病与更高的精神健康障碍患病率相关。然而，在孟加拉国同时患有糖尿病和高血压的成年人中，广泛性焦虑障碍（GAD）和抑郁症的患病率缺乏相关证据。我们旨在评估孟加拉国农村地区同时患有糖尿病和高血压合并症的成年人中广泛性焦虑障碍和抑郁症的患病率，并探讨相关因素。
我们开展了一项横断面研究。
该研究在孟加拉国迪纳杰布尔县的一个乡Chirirbandar进行。
我们共访谈了387名同时患有糖尿病和高血压合并症的成年人。
我们有两个主要结局指标：广泛性焦虑障碍和抑郁症。在广泛性焦虑障碍-7量表上得分≥10分的个体被视为患有广泛性焦虑障碍，在患者健康问卷-9量表上得分≥10分的个体被视为患有抑郁症。根据这些分数将结局变量进行二分法分类。
广泛性焦虑障碍的患病率为7.24%（95%置信区间5.04至10.29）。教育水平（5-9年级）（调整后比值比（AOR）：3.40，95%置信区间1.26至9.19）和家庭财富状况（最高财富三分位数）（AOR：0.12，95%置信区间0.02至0.62）与广泛性焦虑障碍相关。抑郁症的患病率为17.83%（95%置信区间14.32至21.98）。与抑郁症相关的社会经济因素包括失业（AOR：3.26，95%置信区间1.05至10.10）和家庭财富状况（最高财富三分位数）（AOR：0.45，95%置信区间0.21至0.98）。在血压得到控制的参与者中也观察到较高的抑郁症患病几率（AOR：3.88，95%置信区间1.81至8.35）。其他因素，如烟草使用、饮食多样性和身体活动，与广泛性焦虑障碍或抑郁症无关。
在同时患有糖尿病和高血压合并症的成年人中观察到较高的广泛性焦虑障碍和抑郁症患病率。该研究结果强调需要将精神卫生服务纳入现有的非传染性疾病护理中。在为孟加拉国患有高血压和糖尿病合并症的人群制定针对性干预措施时，应考虑已确定的与广泛性焦虑障碍或抑郁症相关的因素。
