The relationship between patterns of noncommunicable diseases and depressive symptoms in rural population: a latent class analysis.

AIM: Noncommunicable diseases (NCDs) may exacerbate mental health problems in urban populations. However, the extent to which multimorbidity of NCDs influences depressive symptoms among rural populations is unclear. This study evaluated multimorbidity patterns of NCDs and examined their relationship with depressive symptoms in individuals aged 15 years and older living in rural areas.

METHOD: A cross-sectional study using data from a representative sample of the rural Brazilian population (N = 20,973) were analysed. Latent class analysis was used to identify multimorbidity patterns across eleven NCDs. Associations between multimorbidity patterns and depressive symptoms were tested using logistic regression models adjusted for demographics, socioeconomic factors and behaviours.

RESULTS

The mean age of the sample was 43.4 years and 47.3% of the participants were female. Four multimorbidity clusters were depicted: class 1: low morbidity class, class 2: musculoskeletal-cardiometabolic cluster, class 3: complex multimorbidity cluster, and class 4: cardiometabolic-oral health cluster. Higher-prevalence patterns (classes 2-4) were associated with major depression (Class 2, OR = 8.9 [95%CI 5.3-15.1]; Class 3, OR = 8.5 [95%CI 5.3-13.6]; Class 4, OR = 2.3 [95%CI 1.3-4.1]) and other depression (Class 2, OR = 2.2 [95%CI 1.3-3.9]; Class 3, OR = 4.3 [95%CI 2.4-7.4]; Class 4, OR = 1.8 [95%CI 1.2-2.9]).

CONCLUSION

Distinct clusters of multimorbidity of NDCs play a significant role in depressive symptoms in rural people. The development of depression screening and early interventions in rural healthcare services for individuals with multimorbidity may mitigate the long-term mental health problems consequences.