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Depression and anxiety among hypertensive and diabetic primary health care patients. Could patients' perception of their diseases control be used as a screening tool?

ABSTRACT: To measure the frequency and identify risk factors of depression and anxiety among diabetic and hypertensive primary health care (PHC) patients. Also to assess whether patients' perception of their chronic diseases control and sleep disturbance could serve as screening tools for depression and anxiety. Methods: This cross-sectional study of 368 PHC patients was conducted in AlKhobar city, Kingdom of Saudi Arabia between April and May 2015. Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used as diagnostic tools for depression and anxiety. Results: Frequencies, cross-tabulations and logistic regression tests were performed. Patient's perception of chronic diseases control was significantly associated with the presence of depression and anxiety, while it was not seen in the tested disease control (glycated hemoglobin less than 7% and blood pressure less than 140/90 mm Hg). Sleep disturbance has a high specificity (98.9%) in screening for depression. Overall prevalence of depression or anxiety was 57.3% and detected cases was 23%. Depression comprise 48.7% (39.8% mild, 7.1% moderate, 1.8% severe). Anxiety comprise 38.4% (25.1% mild, 8.8% moderate, 4.4% severe). Co-existence of both disorders was 29.5%. Sleep disturbance, weight change, and low income had an independent significant effect on depression and anxiety. Conclusion: Having no sleep disturbance can rule out 98.9% of depression and anxiety cases. Patient's feelings should be considered in chronic diseases health care plans. Depression or anxiety among diabetic and hypertensive patients have a high morbidity, but with low detection rate.

SUBMITTER: AlKhathami AD

PROVIDER: S-EPMC5541186 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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Project description:BackgroundBack pain patients are more likely to suffer from depression, anxiety and reduced quality of life. Pain drawing is a simple, frequently used anamnesis tool that facilitates communication between physicians and patients. This study analysed pain drawings to examine whether pain drawing is suitable as a screening tool for signs of anxiety, depression or reduced quality of life, as the detection of these symptoms is essential for successful treatment.MethodsPain drawings of 219 patients with lower back pain were evaluated retrospectively. Pain drawings are a schematic drawing of a human being. Six variables of the pain drawing were analysed. Subscales of the Hospital Anxiety and Depression Scale (HADS) and the Mental Component Summary (MCS) of the Short Form 12 (SF-12) were used to measure anxiety, depression and quality of life, respectively. Descriptive statistics, uni- and multivariate linear regression analyses and analysis of variance were performed. Logistic regression analyses were conducted for suitable variables.ResultsWe revealed significant positive correlations between the variables "filled body surface" and "number of pain sites" and the anxiety (HADS-A) and depression subscales (HADS-D) of the HADS (p<0.01). The same predictors had significant negative correlations with the MCS (p<0.01). However, the sensitivity and specificity of the variable "number of pain sites" were too low compared to those for existing screening tests to consider it as a screening tool for anxiety, depression and quality of life (HADS-A: sensitivity: 45.2%, specificity: 83.3%; HADS-D: sensitivity: 61.1%, specificity: 51%; MCS: sensitivity: 21.2%, specificity: 85.7%).ConclusionsThere were significant correlations between the amount of filled body surface and the number of pain sites in the pain drawing and anxiety, depression and quality of life. Although useful in routine clinical practice, pain drawing cannot be used as a screening tool based on our results.

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Depression and anxiety among hypertensive and diabetic primary health care patients. Could patients' perception of their diseases control be used as a screening tool?

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