Multimorbidity, depression with anxiety symptoms, and decrements in health in 47 low- and middle-income countries

被引:23
作者
Felez-Nobrega, M. [1 ,2 ]
Haro, J. M. [1 ,2 ]
Koyanagi, A. [1 ,2 ,3 ]
机构
[1] Parc Sanitari Sant Joan De Deu, Res & Dev Unit, Barcelona, Spain
[2] Ctr Biomed Res Mental Hlth CIBERSAM, Barcelona, Spain
[3] ICREA, Pg Lluis Co 23, Barcelona, Spain
关键词
Depression; Anxiety; Low- and middle-income countries; Multimorbidity; CHRONIC PHYSICAL CONDITIONS; COMMUNITY-DWELLING ADULTS; GLOBAL MENTAL-HEALTH; SEDENTARY BEHAVIOR; GENERAL-POPULATION; COMORBID ANXIETY; OLDER-ADULTS; ALL-CAUSE; ASSOCIATION; DISORDER;
D O I
10.1016/j.jad.2022.08.110
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Comorbid depression and anxiety is associated with worse health outcomes compared to depression or anxiety occurring in isolation, but there is little data on its association with multimorbidity. Thus, we investigated this association across 47 low- and middle-income countries, and further explored whether having anxiety symptoms in addition to depression is associated with significant declines in health outcomes among those with multimorbidity. Methods: Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. DSM-IV depression was assessed with the Composite International Diagnostic Interview. Anxiety symptoms referred to severe/extreme problems with worry or anxiety. Ten chronic conditions and health status across five domains (cognition, interpersonal activities, sleep/energy, self-care, pain/discomfort) were assessed. Multivariable regression analyses conducted. Results: Data included 237,952 adults aged >= 18 years [mean age (SD) 38.4 (16.0); 50.8 % females]. Compared to no chronic conditions, 2 (OR = 6.86; 95%CI = 5.59-8.42), 3 (OR = 12.33; 95%CI = 9.72-15.63), and >= 4 (OR = 26.55; 95%CI = 20.21-35.17) chronic conditions were associated with significantly higher odds for comorbid depression/anxiety symptoms (vs. no depression or anxiety symptoms) in the multinomial logistic regression model. Among those with depression and multimorbidity, anxiety symptoms were associated with significantly worse health status across all domains. Limitations: Cross-sectional design, depression and anxiety symptoms were not based on a clinical assessment. Conclusions: Comorbid depression/anxiety is common in people with multimorbidity, and anxiety symptoms in people with depression and multimorbidity signify worse health status. Future studies should assess the utility of screening for and treating comorbid depression/anxiety in patients with multimorbidity in terms of clinical outcomes.
引用
收藏
页码:176 / 184
页数:9
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