Comorbid Anxiety and Depression Among Patients Attending the General Outpatient Clinic of a Nigerian Teaching Hospital
DOI:
https://doi.org/10.30442/ahr.1001-05-224Abstract
Background: Anxiety and depression are common mental disorders that are not only on the increase, but their comorbidity accounts for greater severity, chronicity, functional limitations and significant impairment of physical health.
Objective: The objective of this study is to determine the prevalence of comorbid anxiety and depression (CAD) among patients attending the General Outpatient Clinic, which could help increase the index of suspicion of these disorders and subsequently improve overall patient care.
Methods: A hospital-based cross-sectional study was carried out at the General Outpatient Clinic of Bowen University Teaching Hospital, Ogbomoso, between August and November 2021. Using a systematic sampling technique, 222 respondents were recruited. CAD was evaluated using the Generalized Anxiety Disorder Scale and Patient Health Questionnaire. SPSS version 26 was used for data analysis. Frequency and percentages were calculated, and Chi-square was used to test for significant association with a p-value set at <0.05.
Results: CAD was found among 27.5% of the study participants. Age group above 75 years, male gender, married participants, skilled workers, participants having monthly income between ₦51,000 - ₦100,000 (equivalent to USD100-200) and those with diabetes had the highest prevalence of CAD. Male gender had a statistically significant association with CAD.
Conclusion: It is, therefore, imperative to increase awareness of CAD with a focus on the male gender to commence treatment promptly when identified.
References
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Groen RN, Ryan O, Wigman JTW, Riese H, Penninx BWJH, Giltay EJ, et al. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med 2020;20:1–17. https://doi.org/10.1186/s12916-020-01738-z.
Ogbolu RE, Omidiji OA. A study of anxiety and depression among patients undergoing radiological investigations in a Nigerian Tertiary Hospital. J Clin Sci 2018;15:41–47. https://doi.org/10.4103/jcls.jcls.
Rajan S, Krishna A, Muliyala KP, Chaturvedi SK. Comorbidity of anxiety and depression with hypertension, diabetes, and cardiovascular disease : A selective systematic review from India. EMJ Diabet 2022.: https://doi.org/10.33590/emjdiabet/21-00189.
Dike-Israel NA, Akinboye DO. Prevalence and comorbidity of depression and anxiety among medical students in Babcock University, Ogun State, Nigeria. Asian J Med Health 2021;19:46–55. https://doi.org/10.9734/AJMAH/2021/v19i430321.
Aluh DO, Abba A, Afosi AB. Prevalence and correlates of depression, anxiety and stress among undergraduate pharmacy students in Nigeria. Pharm Educ 2020;20:236–248. https://doi.org/10.46542/pe.2020.201.236248
Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M. Comorbid generalised anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep 2017;7:1–8. https://doi.org/10.1038/srep40511
Zbozinek T, Rose R, Wolitzky-Taylor K, Sherbourne C, Sullivan G, Stein MB, et al. Diagnostic overlap of generalised anxiety disorder and major depressive disorder in a primary care sample. Depress Anxiety. 2012;29:1065–1071. https://doi.org/10.1002/da.22026.
Bante A, Mersha A, Zerdo Z, Wassihun B, Yeheyis T. Comorbid anxiety and depression : prevalence and associated factors among pregnant women in Arba Minch zuria district, Gamo Zone, Southern Ethiopia. PLOS Med. 2021;16:1–15. https://doi.org/10.1371/journal.pone.0248331.
Hamrah MS, Hamrah MH, Ishii H, Suzuki S, Hamrah MH, Hamrah AE, et al. Anxiety and depression among hypertensive outpatients in Afghanistan : a cross-sectional study in Andkhoy City. Int J Hypertens 2018:2018:8560835. 1–9. https://doi.org/10.1155/2018/8560835.
Akinsulore A, Adeseiye OC, Oloniniyi IO, Esimai OA. Prevalence and factors associated with comorbid depression and anxiety among older adults in southwestern Nigeria: a community-based study. Ann Health Res 2020;6:421–431. https://doi.org/10.30442/ahr.0604-07-105.
Albert UK, Effiong JH. Mental Health in Primary Care: Comorbid Anxiety and Depression in Akwa Ibom State, Nigeria. Int Neuropsychiatr Dis J 2015;4:102–107. https://doi.org/10.9734/INDJ/2015/18664.
Shimada F, Ohira Y, Hirota Y, Ikegami A, Kondo T, Shikino K, et al. Anxiety and depression in general practice outpatients : the long-term change process. Int J Gen Med 2018;11:55–63. https://doi.org/10.2147/IJGM.S130025.
Aika IN, Odili VU. Depression and anxiety among HIV patients in a treatment centre in Nigeria. HIV AIDS Rev 2019;18:107–114. https://doi.org/10.5114/hivar.2019.86375.
Kugbey N. Comorbid anxiety and depression among women receiving care for breast cancer: analysis of prevalence and associated factors. Afri Health Sci 2022;22:166–172. https://doi.org/10.4314/ahs.v22i3.19.
Camara A, Sow MS, Toure A, Sako FB, Camara I, Soumaoro K, et al. Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018. Epidemiol Infect 2020;148:1–6. https://doi.org/10.1017/S095026881900222X.
Nkporbu AK, Korubo IF, Stanley CN. Pattern and prevalence of psychiatric comorbidity among people living with HIV ( PLWHIV ) at the University of Port Harcourt Teaching Hospital ( UPTH ). World J Adv Res Rev 2023;17:697–708. https://doi.org/10.30574/wjarr.2023.17.2.0987.
Risal A, Manandhar K, Linde M, Steiner TJ, Holen A. Anxiety and depression in Nepal : prevalence, comorbidity and associations. BMC Psychiatry 2016;16:1–9. https://doi.org/10.1186/s12888-016-0810-0.
Ezeme MS, Dinwoke VO, Ohayi SR. Risk factors and comorbid anxiety and depression in pregnancy in a tertiary hospital in southeast Nigeria. Int J Med Heal Dev 2018;23:276–283. https://dx.doi.org/10.4314/jcm.v23i2.4
Saha S, Lim CCW, Cannon DL, Burton L, Bremner M, Cosgrove P, et al. Co‐morbidity between mood and anxiety disorders: a systematic review and meta-analysis. Anxiety Depress Assoc Am 2021;38:286–306. https://doi.org/10.1002/da.23113.
Groen RN, Ryan O, Wigman JTW, Riese H, Penninx BWJH, Giltay EJ, et al. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med 2020;20:1–17. https://doi.org/10.1186/s12916-020-01738-z.
Ogbolu RE, Omidiji OA. A study of anxiety and depression among patients undergoing radiological investigations in a Nigerian Tertiary Hospital. J Clin Sci 2018;15:41–47. https://doi.org/10.4103/jcls.jcls.
Rajan S, Krishna A, Muliyala KP, Chaturvedi SK. Comorbidity of anxiety and depression with hypertension, diabetes, and cardiovascular disease : A selective systematic review from India. EMJ Diabet 2022.: https://doi.org/10.33590/emjdiabet/21-00189.
Dike-Israel NA, Akinboye DO. Prevalence and comorbidity of depression and anxiety among medical students in Babcock University, Ogun State, Nigeria. Asian J Med Health 2021;19:46–55. https://doi.org/10.9734/AJMAH/2021/v19i430321.
Aluh DO, Abba A, Afosi AB. Prevalence and correlates of depression, anxiety and stress among undergraduate pharmacy students in Nigeria. Pharm Educ 2020;20:236–248. https://doi.org/10.46542/pe.2020.201.236248
Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M. Comorbid generalised anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep 2017;7:1–8. https://doi.org/10.1038/srep40511
Zbozinek T, Rose R, Wolitzky-Taylor K, Sherbourne C, Sullivan G, Stein MB, et al. Diagnostic overlap of generalised anxiety disorder and major depressive disorder in a primary care sample. Depress Anxiety. 2012;29:1065–1071. https://doi.org/10.1002/da.22026.
Bante A, Mersha A, Zerdo Z, Wassihun B, Yeheyis T. Comorbid anxiety and depression : prevalence and associated factors among pregnant women in Arba Minch zuria district, Gamo Zone, Southern Ethiopia. PLOS Med. 2021;16:1–15. https://doi.org/10.1371/journal.pone.0248331.
Hamrah MS, Hamrah MH, Ishii H, Suzuki S, Hamrah MH, Hamrah AE, et al. Anxiety and depression among hypertensive outpatients in Afghanistan : a cross-sectional study in Andkhoy City. Int J Hypertens 2018:2018:8560835. 1–9. https://doi.org/10.1155/2018/8560835.
Akinsulore A, Adeseiye OC, Oloniniyi IO, Esimai OA. Prevalence and factors associated with comorbid depression and anxiety among older adults in southwestern Nigeria: a community-based study. Ann Health Res 2020;6:421–431. https://doi.org/10.30442/ahr.0604-07-105.
Albert UK, Effiong JH. Mental Health in Primary Care: Comorbid Anxiety and Depression in Akwa Ibom State, Nigeria. Int Neuropsychiatr Dis J 2015;4:102–107. https://doi.org/10.9734/INDJ/2015/18664.
Shimada F, Ohira Y, Hirota Y, Ikegami A, Kondo T, Shikino K, et al. Anxiety and depression in general practice outpatients : the long-term change process. Int J Gen Med 2018;11:55–63. https://doi.org/10.2147/IJGM.S130025.
Aika IN, Odili VU. Depression and anxiety among HIV patients in a treatment centre in Nigeria. HIV AIDS Rev 2019;18:107–114. https://doi.org/10.5114/hivar.2019.86375.
Kugbey N. Comorbid anxiety and depression among women receiving care for breast cancer: analysis of prevalence and associated factors. Afri Health Sci 2022;22:166–172. https://doi.org/10.4314/ahs.v22i3.19.
Camara A, Sow MS, Toure A, Sako FB, Camara I, Soumaoro K, et al. Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018. Epidemiol Infect 2020;148:1–6. https://doi.org/10.1017/S095026881900222X.
Nkporbu AK, Korubo IF, Stanley CN. Pattern and prevalence of psychiatric comorbidity among people living with HIV ( PLWHIV ) at the University of Port Harcourt Teaching Hospital ( UPTH ). World J Adv Res Rev 2023;17:697–708. https://doi.org/10.30574/wjarr.2023.17.2.0987.
Risal A, Manandhar K, Linde M, Steiner TJ, Holen A. Anxiety and depression in Nepal : prevalence, comorbidity and associations. BMC Psychiatry 2016;16:1–9. https://doi.org/10.1186/s12888-016-0810-0.
Ezeme MS, Dinwoke VO, Ohayi SR. Risk factors and comorbid anxiety and depression in pregnancy in a tertiary hospital in southeast Nigeria. Int J Med Heal Dev 2018;23:276–283. https://dx.doi.org/10.4314/jcm.v23i2.4
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