Association between depression, anxiety and quality of life among patients with diabetes mellitus and/or hypertension in a tertiary care railway hospital in India: A cross-sectional study

Abstract

Introduction: Comorbid depression and anxiety have been found to be highly present in patients suffering from chronic physical illnesses such as diabetes mellitus (DM) and hypertension (HTN). These comorbid psychiatric conditions further reduce the quality of life (QOL) in the sufferers. The present study aimed to assess the association between depression, anxiety, and QOL among patients with DM and/or HTN. Materials and Methods: This cross-sectional study was carried out in the outpatient setting of the medicine department of the tertiary care referral hospital of East Central Indian Railways. One hundred and twenty-three individuals of DM and/or HTN of more than 1-month duration were assessed for depression, anxiety, and QOL using the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization QOL Brief (WHOQOL-BREF) version scale. Results: The mean age of the sample (53.7% had HTN, 12.2% had diabetes, and 34.1% had both HTN and diabetes) which comprised 87% males was 50.20 (±6.0) years. The mean HADS (anxiety and depression) scores were 3.6 for both (range 0-14). Nearly 10.6% and 17.1% of the samples had scores above the cutoff for HADS anxiety and depression subscales. The WHOQOL-BREF scores were highest for the environmental domain and were lower for psychological, physical, and social domains. The HADS anxiety and depressive scores correlated significantly negatively with the WHOQOL-BREF physical and psychological domains. Female gender and the presence of an additional medical illness were significantly associated with higher HADS depression scores. Conclusion: Fair proportion of patients with HTN and/or diabetes has been affected with higher anxiety and depressive scores, which predicted a poor QOL. This calls for early identification of these mental health issues in sufferers of depression and HTN, which will facilitate an early holistic management.