Academic journal article South African Journal of Psychiatry

Anxiety and Depressive Features in Chronic Disease Patients in Cambodia, Myanmar and Vietnam

Academic journal article South African Journal of Psychiatry

Anxiety and Depressive Features in Chronic Disease Patients in Cambodia, Myanmar and Vietnam

Article excerpt

Introduction

Depression and anxiety are common in people with chronic diseases. (1) Clark and Currie (2) (p. 190) reviewed that 'depression is more common in patients with heart disease, stroke, diabetes mellitus, asthma, cancer, arthritis and osteoporosis and anxiety is more common in people with heart disease, stroke and cancer than in the general population'. Cross-sectional studies have reported that the prevalence of co-morbid anxiety and depression is high in patients with chronic heart failure and chronic obstructive pulmonary disease (COPD). (3) Scott et al. (4) found that anxiety and depression were associated with diabetes, asthma, hypertension, arthritis, ulcer, heart disease, back/neck problems, chronic headache and multiple pains. Anxiety disorders were associated with hypertension. (5) Hochstrasser and Angst (6) found that stomach and intestinal complaints were associated with depressive and anxiety disorders. Psychiatric co-morbidities, particularly mood and anxiety disorders, were found to be more common among persons with migraine or frequent headaches. (7) In Latinos living in the United States, anxiety was associated with diabetes and cardiovascular disease and depression and co-occurring anxiety and depression were positively associated with having a history of asthma. (8) Anxiety disorders were also found to be associated with Parkinson's disease (9) and anxiety and depressive disorders with kidney disease. (10)

Katon, Lin and Kroenke (11) (p. 153) found that patients with chronic medical illness and co-morbid depression or anxiety compared to those with chronic medical illness alone reported significantly higher numbers of medical symptoms when controlling for severity of medical disorder. Similarly, a higher number of comorbidities was associated with anxiety and depression. (12)

In studies in low- and middle-income countries, for example, Turkey, it was found that the prevalence of anxiety disorder in hypertension was 9.5% and that for diabetes was 16.0% (13) and a prevalence of depressive disorder in hypertension was 5.2% and that for diabetes was 22.7%. (13) In patients with diabetes, co-morbid depression was found to have a prevalence of 23.0% - 39.2% in China and 16.9% - 84.0% in India. (14) The prevalence of depression was 28.3% in patients with chronic disease (arthritis 10.6%, diabetes 48.1% and heart disease 20.2%) in Trinidad. (15) Among Indian patients with chronic disease, 14.7% mental distress was found in patients with diabetes, 17.1% in those with hypertension and 13.3% in those with arthritis. (12) In a population undergoing haemodialysis in Nigeria, 35.0% had a major depressive episode and 29.0% had a generalised anxiety disorder. (10)

In systematic reviews, the prevalence of depression using self- or clinician-administered rating scales in patients with chronic kidney disease was found to be 39.3%, (16) and in a review, the prevalence of depressive disorder was found to be 14.8% in patients with arthritis. (17) Furthermore, anxiety and depressive disorders in patients with chronic diseases have been found to be associated with poorer quality of life (18) and various sociodemographic factors such as low educational level. (15) The aim of this study was to estimate the prevalence and relationship of anxiety and depressive features among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam).

Methods

Sample and procedure

In each Southeast Asian country (Cambodia, Myanmar, Vietnam), a cross-sectional survey in conveniently sampled rural and urban health facilities was conducted on outpatients with chronic diseases. The sample size included at least 800 persons from rural health facilities and 800 individuals from urban health facilities in each country. Every eligible patient (18 years and above and having been treated for a chronic disease in the past 12 months) (19) was selected from the health facility, using a consecutive sampling procedure. …

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