Associations of Underlying Health Conditions With Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors.

Minh H Nguyen,Hung Q Nguyen,Hung K Dao,Huu C Nguyen,Tung H Ha,Khue M Pham,Cuong Q Tran,Dung T Phan,Tien V Tran,Trang T Duong,Manh V Trinh,Tuyen Van Duong,Phuoc B Nguyen,Nga H Dang ,Thuy Le ,Chyi‐Huey Bai ,Dong-Soo Ha ,Lam Van Nguyen ,Huong T.m Ngo ,Tam T Vo ,Hoang Cong Nguyen ,Tan Tien Nguyen ,Nhan P.t Nguyen ,Thuy T.t ,Tram Anh-Nguyen Ngoc ,Linh Pham ,V Thinh ,Thu Trang Pham ,Khanh Van Tran ,N Binh ,Kien Trung Nguyen ,Hoai Than Nguyen ,Thao Thanh Nguyen

doi:10.3389/ijph.2021.634904

Abstract

Objectives: We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB). Methods: A cross-sectional study was conducted on 8,291 outpatients aged 18–85 years, in 18 hospitals and health centers across Vietnam from 14th February to May 31, 2020. We collected the data regarding participant's characteristics, UHC, HB, PB, depression, and anxiety. Results: People with UHC had higher odds of depression (OR = 2.11; p < 0.001) and anxiety (OR = 2.86; p < 0.001) than those without UHC. The odds of depression and anxiety were significantly higher for those with UHC and S-COVID-19-S (p < 0.001); and were significantly lower for those had UHC and interacted with “unchanged/more” physical activity (p < 0.001), or “unchanged/more” drinking (p < 0.001 for only anxiety), or “unchanged/healthier” eating (p < 0.001), and high PB score (p < 0.001), as compared to those without UHC and without S-COVID-19-S, “never/stopped/less” physical activity, drinking, “less healthy” eating, and low PB score, respectively. Conclusion: S-COVID-19-S worsen psychological health in patients with UHC. Physical activity, drinking, healthier eating, and high PB score were protective factors.

Highlights

The COVID-19 pandemic has been influencing unprecedentedly all aspects of life [1, 2]
We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB)
Of 8,291 participants, 41% were men, 79.9% ever married, 45.5% had college/university or higher degree, 92.5% had a job, 45.9 reported felt very or fairly easy to pay for treatments, 28.7% participated in surveying during the lockdown period, 11.7% were overweight or obese, and 37.7% had S-COVID-19-S

Summary

Introduction

The COVID-19 pandemic has been influencing unprecedentedly all aspects of life [1, 2]. Adopting preventive behaviors and healthy lifestyles was strongly advised for the public to stay well during this difficult time [7, 8]. Compliance with preventive measures is the most recommended strategies to effectively control the spread of COVID-19 across countries [9]. Engaging in preventive behaviors could help to prevent COVID-19 transmission and infection [12], which may reduce the fear and other mental health problems [13]. Recent literature has shown that following to healthy lifestyle such as doing exercise, eat healthier may help boost the immune system, reduces the risk of infection [14,15,16], which may further help control the unfavorable influences of the pandemic on psychological health

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