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

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.