Depression among Peruvian adults with hypertension and diabetes: Analysis of a national survey

Self-reported depression and its risk factors among hypertensive patients, Morocco: a cross-sectional study

Hypertensive patients are at an elevated risk of developing mental diseases such as depression, which can impair their quality of life. The purpose of this study is to measure the prevalence of self-reported depression among hypertensive patients treated at primary health care facilities in Marrakech. Between May 2021 and December 2022, a cross-sectional study of 1053 hypertensive patients attending primary health care facilities in Marrakech was conducted. A face-to-face questionnaire was used to collect socio-demographic, behavioral, and clinical data, as well as hypertension treatment characteristics and the care-patient-physician triad. The Patient Health Questionnaire-9 was used to assess self-reported depression. To identify self-reported depression risk factors, multivariate logistic regression was used. Depressive symptoms were reported by 56.1% of hypertensive patients. The patients' average age was 63.2 ± 9.5 years, and 508 (85.9%) were female. Female sex, stress, a low-salt diet, pain and physical discomfort, an urban living environment, a lack of self-monitoring of hypertension, an unsatisfactory relationship with the healthcare system, a family history of hypertension, and the perception of adverse effects of the antihypertensive drug were all associated with self-reported depression. Self-reported depression is prevalent among hypertensive patients in Marrakech. The mental health component should be emphasized while addressing hypertensive patients in primary health care facilities.

Observational and genetic analyses of the bidirectional relationship between depression and hypertension

BACKGROUND

While the association between depression and hypertension has been extensively investigated, the pattern and nature of such association remain inconclusive. We sought to investigate the bidirectional relationship between depression and hypertension and its causal.

METHODS

We first performed observational analyses using longitudinal data from the UK Biobank. We then performed genetic analyses leveraging summary statistics from large-scale genome-wide association studies (GWASs) conducted in European ancestry for depression and hypertension.

RESULTS

Observational analysis suggested a significant bidirectional phenotypic association between depression and hypertension (Depression → Hypertension: HR = 1.27, 95 % CI: 1.19, 1.36; Hypertension → Depression: HR = 1.65, 95 % CI: 1.58, 1.72). Linkage disequilibrium score regression demonstrated a positive genetic correlation between the two conditions (rg=0.15, P = 5.75 × 10-10). Bidirectional two-sample Mendelian randomization (MR) suggested that genetic liability to depression was significantly associated with an increased risk of hypertension (OR = 1.27, 95 % CI: 1.12, 1.43), while the genetic liability to hypertension was not associated with the risk of depression (OR = 1.01, 95 % CI: 0.99, 1.03). Multivariate MR, after adjusting for smoking, drinking, and body mass index, further supported an independent causal effect of genetic liability to depression on hypertension risk (OR = 1.10, 95 % CI: 1.02, 1.18).

LIMITATIONS

(1) interference of confounders, (2) absence of adequate statistical power, and (3) limitation to European populations.

CONCLUSION

Our study indicates depression is a causal risk factor for hypertension, whereas the reverse maybe not. Findings support that prevention of depression might help in decreasing hypertension incidence.

Prevalence of depression among clients with diabetes and hypertension in selected hospital at Mangaluru, India

BACKGROUND

Non-communicable diseases are lifestyle diseases that are increasing throughout the world. They are responsible for 71% of death worldwide, among which 16 million people die prematurely or before reaching the age of 70 years. Among the non-communicable diseases, diabetes and hypertension are the most common. The study aimed to find the prevalence of depression among diabetes and hypertensive clients.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted among 370 subjects diagnosed with diabetes mellitus, hypertension, and both in Justice K.S Hegde Charitable Hospital at Mangaluru. A purposive sampling technique was adopted to select the subjects. Patient health questionnaire-9 (PHQ-9) was used to find the depressive symptoms among the client. The statistical analysis was conducted using SPSS version 20 (Armonk, NY: IBM Corp.); descriptive (frequency and percentage) and inferential (one-way analysis of variance (ANOVA)) statistics were used to interpret the data.

RESULTS

Out of 370 subjects, 41% had no depression, and most 59% had mild to severe levels of depression. Among clients diagnosed with diabetes mellitus (n = 139), the majority (63%) had mild to severe depression. Similarly, of subjects diagnosed with hypertension, 51% had no depression, and 49% had mild to severe depression. In addition, among subjects diagnosed with both diabetes mellitus and hypertension (n = 99), 67% had mild to severe depression.

CONCLUSIONS

The study shows that many diabetes and hypertensive patients attending the outpatient departments of the hospital experience depression. So, it is crucial to identify the depressive symptoms early and take appropriate measures to prevent complications.

The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study

BACKGROUND

The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30-59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer).

METHODS

This cross-sectional study utilized data from the 2018 Indonesian National Health Survey (Riskesdas). The study population comprised respondents aged between 30 and 59 years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents. Data were analyzed using logistic regression.

RESULTS

Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex, education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481-9.928; p<0.001).

CONCLUSION

The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.

Associations of road traffic noise and its frequency spectrum with prevalent depression in Taichung, Taiwan

Introduction

Exposure to road traffic noise has been reported to be associated with depression in many epidemiological studies, but the association between noise frequency spectrum and depression remains unclear. This community-based study investigated the associations between road traffic noise exposure and its frequency components with prevalent depression.

Methods

A total of 3,191 residents living in Taichung who participated in the Taiwan Biobank between 2010 and 2017, were included as study participants. The land-use regression models were used to evaluate individual annual average values of A-weighted equivalent sound level over 24 h (L_eq,24h) and particulate matter with an aerodynamic diameter <2.5 μm (PM_2.5) using the geographic information system. Multiple logistic regression was applied to estimate the odds ratios (ORs) for depression after adjusting for potential risk factors and PM_2.5.

Results

An interquartile range increase in L_eq,24h at full frequency (4.7 dBA), 1,000 Hz (5.2 dB), and 2,000 Hz (4.8 dB) was significantly associated with an elevated risk for depression with ORs of 1.62 (95% confidence interval [CI]: 1.03, 2.55), 1.58 (95% CI: 1.05, 2.37), and 1.58 (95% CI:1.03, 2.43), respectively, by controlling for PM_2.5. The high-exposure group (≥3rd quartile median of noise levels) at full frequency, 1,000 Hz, and 2,000 Hz had an increased risk for depression with ORs of 2.65 (95% CI: 1.16-6.05), 2.47 (95% CI: 1.07-5.70), and 2.60 (95% CI: 1.10-6.12), respectively, compared with the reference group (<1st quartile of noise levels) after adjustment for PM_2.5. Significant exposure-response trends were observed between the prevalent depression and noise exposure by quartiles at full frequency, 1,000 Hz, and 2,000 Hz (all p < 0.05).

Conclusion

Exposure to road traffic noise may be associated with an increased prevalence of depression, particularly at 1,000 and 2,000 Hz.

The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: A national survey in South Africa

Objective and methods

Mental health problems among adults are a growing public health concern, and middle-income countries such as South Africa are disproportionally affected. Using a large scale nationally representative weighted survey, we assessed the prevalence of probable depression, probable anxiety, and adverse childhood experiences (ACEs), and explored associations between probable depression, probable anxiety, ACEs, socio-economic status, and demographic characteristics.

Results

Nationally, 25.7, 17.8, and 23.6% of respondents, respectively, reported scores of ≥10 on the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), indicating probable depression or probable anxiety, and an ACE score of ≥4 (high exposure). Overall probable depression prevalence across South Africa varied from 14.7 to 38.8%. Both probable depression and probable anxiety were more frequently reported among adults who were: retired and older (>65 years of age), and widowed, divorced, or separated; living in metropolitan areas; and only had primary school education. In a multivariable adjusted logistic regression, the likelihood of reporting probable depression or probable anxiety was also found to increase with each standard deviation increase in the ACE score (p < 0.001), independent of other socio-demographic determinants.

Conclusion

The prevalence of probable depression among respondents in South Africa varies significantly across the nine provinces. Furthermore, higher ACE score and several socio-demographic determinants were associated with a higher likelihood of probable depression and probable anxiety. Adult mental health services are urgently needed to identify groups of the population vulnerable to mental health problems for better targeting of interventions. Given the range of probable depression prevalence across the country, provincial level plans and resources should also reflect the burden of mental health problems in that province.

Association between maternal depression and emotion and behavior regulation in Peruvian children: a population-based study

Depression is more frequent in women, affecting the early stages of child development. This study aimed to determine the association between maternal depression and self-regulation of emotions and behaviors in Peruvian children under five years. A cross-sectional analytical study of data collected by the 2019 Demographic and Family Health Survey (ENDES) was conducted. The outcome variable was emotion and behavior regulation in children aged 24 to 59 months, and exposure was the presence of depression in women aged 15 to 49 years during the 14 days prior to the survey using the Patient Health Questionnaire (PHQ-9). A generalized linear model of the binomial family was used for reporting crude prevalence ratios and adjusted. The overall prevalence of children who did not self-regulate their emotions and behaviors was 68.8%, while 3.8% of the mothers had moderate depressive symptoms and 2.2% severe symptoms. Regarding the association of interest, moderate and severe depressive symptoms of mothers decreased the probability of children regulating emotions and behaviors in the first model, whereas in the second model, an association was only found with severe depressive symptoms. In conclusion, children of mothers with moderate and severe depressive symptoms had a lower probability of self-regulating their emotions and behaviors. Therefore, it is necessary to develop maternal education, nutritional and social support programs and mental health strategies from the first level of care aimed at reducing social, economic and child factors to reduce the risk of depression in mothers and low early childhood development, which could reduce the risk of developing mental health disorders in adolescence and adulthood.

The network structure of depressive symptomatology in Peruvian adults with arterial hypertension

Background: Globally, arterial hypertension (AH) has increased by 90% over the last four decades, and has increased by 1.6% in Peru over the previous four years. Scientific evidence indicates the prevalence of depressive symptoms in patients with AH and its importance in the comprehensive evaluation of the adult for adherence to clinical treatment. Previous studies carried out in the Peruvian population with AH mostly report the prevalence and associations, but do not indicate which depressive symptoms are more relevant in patients with AH. This study involved a network analysis of depressive symptomatology in Peruvian patients with AH using network estimation. Network analysis is used in this study for analysis, control, and monitoring purposes.

Method: A representative cross-sectional study at the national level, using secondary data from 2019 Demographic and Family Health Survey (ENDES) was performed. The sample used included men and women of age over 17 years diagnosed with AH and was able to respond to Patient Health Questionnaire-9 (PHQ-9).

Results: The symptoms of depressive mood (bridging force and centrality) and energy fatigue or loss (bridge centrality) play an essential role in the network structure, as does the feeling of uselessness in terms of closeness and intermediation.

Conclusion: The study highlighted the symptoms related to depressive mood and energy fatigue or loss as bridging symptoms, which could trigger a depressive episode in patients diagnosed with AH. The results will contribute to developing personalized treatments aimed at patients with specific depressive symptoms who have also been diagnosed with AH. The study analysis presents statistical coefficients of effect size (≤ 0,1 = small; > 0,1 to < 0,5 = moderate; ≥ 0,5 = large) to determine network connections.

Socioeconomic determinants of hypertension and prehypertension in Peru: Evidence from the Peruvian Demographic and Health Survey

Background

Peru is a Latin American country with a significant burden of hypertension that presents worrying rates of disparities in socioeconomic determinants. However, there is a lack of studies exploring the association between those determinants, hypertension and prehypertension in Peruvian population.

Objective

We aimed to assess the association betwgeen socioeconomic determinants, hypertension and prehypertension using a nationally representative survey of Peruvians.

Methods

We performed a cross-sectional analysis of the Peruvian Demographic and Health Survey (2018), which is a two-staged regional-level representative survey. We used data from 33,336 people aged 15 and older. The dependent variable was blood pressure classification (normal, prehypertension and hypertension) following the Seventh Report of the Joint National Committee (JNC-7) on hypertension management. Independent variables were socioeconomic: age, sex, marital status, wealth index, health insurance, education, region and area of residence. Due to the nature of the dependent variable (more than two categories), we opted to use the multinomial regression model, adjusting the effect of the multistage sample using the svy command. We tested interactions with the adjusted Wald test.

Results

The prevalence of prehypertension and hypertension was 33.68% and 19.77%, respectively. Awareness was higher in urban than in rural areas (9.61% vs. 8.31%, p = 0.008). Factors associated with a higher prevalence ratio of both prehypertension and hypertension were age (ratios rose with each age group), male sex (prehypertension aRPR 5.15, 95%CI 4.63–5.73; hypertension aRPR 3.85, 95% CI 3.37–4.40) and abdominal obesity (prehypertension aRPR 2.11, 95%CI 1.92–2.31; hypertension aRPR 3.04, 95% CI 2.69–3.43). Factors with a lower prevalence ratio of both diseases were secondary education (prehypertension aRPR 0.76, 95%CI 0.60–0.95; hypertension aRPR 0.75, 95% CI 0.58–0.97), higher education (prehypertension aRPR 0.78, 95%CI 0.61–0.99; hypertension aRPR 0.62, 95% CI 0.46–0.82), being married/cohabiting (prehypertension aRPR 0.87, 95%CI 0.79–0.95; hypertension aRPR 0.77, 95% CI 0.68–0.87), richest wealth index (only prehypertension aRPR 0.76, 95%CI 0.63–0.92) and living in cities different to Lima (rest of the Coastline, Highlands and Jungle). Having health insurance (only hypertension aRPR 1.26, 95%CI 1.03–1.53) and current drinking (only prehypertension aRPR 1.15, 95%CI 1.01–1.32) became significant factors in rural areas.

Conclusions

We evidenced socioeconomic disparities among people with hypertension and prehypertension. Better health policies on reducing the burden of risk factors are needed, besides, policy decision makers should focus on hypertension preventive strategies in Peru.

Disability and severe depression among Peruvian older adults: analysis of the Peru Demographic and Family Health Survey, ENDES 2017

BACKGROUND

Depression is considered a mental health-related disability that affects approximately 350 million people worldwide. On the other hand, it is estimated that 15% of the world's population lives with some form of disability, and this scenario is currently riddled with the global burden of mental disorders, non-communicable diseases and other age-related comorbidities.

AIM

To assess the association between disability and depression among Peruvian older adults.

METHODS

We used data from the 2017 Peru Demographic and Familiar Health Survey, with a focus on adults aged 50 years and older. Whereas the presence of disability was assessed using different questions of the survey, depression was measured with the Patient Health Questionnaire-9 (PHQ-9). We calculated the adjusted prevalence ratios (aPR) using Poisson regression models with log link function, with their respective 95% confidence intervals (95% CI).

RESULTS

From the study population, 5% had a disability. In addition, 43.3% were screened positive for depression (13.2% for moderately severe/severe). After adjusting for confounding variables, disability was associated with moderate and severe depression (aPR: 1.06; 95% CI: 1.01-1.11, aPR: 1.10; 95% CI: 1.05-1.15).

CONCLUSION

Disability was positively associated with moderate and severe depression. Public health policies should address the early diagnosis and rehabilitation of patients with any of these problems. Likewise, coping strategies should be promoted among families of persons with disabilities.