Comorbid Depressive and Anxiety Symptoms and Their Correlates Among 93,078 Multiethnic Adults in Southwest China.

Qiaolan Liu,Songmei Wang,Pingcuo Wangqing,Peng Luo,Huan Song,Yuanyuan Liu,Xing Zhao,Jing Zhou,Xiang Liu,Zhuozhi Shen,Yangji Baima

doi:10.3389/fpubh.2021.783687

Abstract

Background: Depressive symptoms and anxiety symptoms commonly coexist and severely increases the disease burden worldwide. Little is known about the patterns and correlates of comorbid depressive and anxiety symptoms among the multiethnic populations of China.Methods: This population-based study investigated the comprehensive associations of comorbid depressive and anxiety symptoms with lifestyles, stressful life events, chronic diseases, and physical and mental well-being among 93,078 participants (37,193 men, 55,885 women) aged 30–79 years across seven ethnic groups in Southwest China. Multivariable logistic regression models were used to estimate associations.Results: Overall, 2.9% (2.1% in men and 3.5% in women) participants had comorbid depressive and anxiety symptoms; there was considerable heterogeneity among multiethnic populations. Participants with chronic diseases were more likely to have comorbidity than those without them; people with rheumatic heart disease reported the highest risk, with an odds ratio (OR) of 6.25 and 95% confidence interval (CI) of 4.06–9.62. Having experienced 3 or more stressful life events (OR, 8.43, 95% CI: 7.27–9.77), very poor self-rated health status (OR, 33.60, 95%CI: 25.16–44.87), and very unsatisfied life (OR, 33.30, 95% CI: 23.73–46.74) had strong positive associations with comorbid depressive symptoms and anxiety symptoms, with a dose-response relationship (P < 0.05). High frequency of physical activity had negative associations. All the associations were stronger than depressive symptoms alone or anxiety symptoms alone.Conclusions: Our findings emphasize the need to focus on the vulnerable ethnic groups with comorbid depressive and anxiety symptoms, ultimate for help early prevention and improvement of health equity in the underdevelopment and high urbanization areas.

Highlights

Depression and anxiety are two highly prevalent and disabling mental disorders that commonly coexist [1, 2]
Higher risks of comorbid depressive and anxiety symptoms were associated with female sex and low socioeconomic status, including poorer education, lower household income, and being widowed; the correlates were similar to depressive symptoms alone or anxiety symptoms alone
We found that all chronic diseases and cancers were associated with comorbid depressive and anxiety symptoms; the associations were stronger than depressive symptoms alone or anxiety symptoms alone

Summary

Introduction

Depression and anxiety are two highly prevalent and disabling mental disorders that commonly coexist [1, 2]. Comorbid depression and anxiety can occur in individuals of all ages, seriously impairing social function, increasing psychosocial disability, and reducing the quality of life. Mental and substance use disorders account for 7.4% of all disability-adjusted life years (DALYs) worldwide, in which depressive disorder account for 40.5% and anxiety disorders account for 14.6% [5]. Identifying and managing comorbidities is essential because depression and anxiety, even if they are independent, contribute to a significant proportion of the global burden of disease [4, 6, 7]. Depressive symptoms and anxiety symptoms commonly coexist and severely increases the disease burden worldwide.

Results

Discussion

Conclusion