Abstract
BackgroundThe developing world is faced with a high burden of anxiety disorders. The exact prevalence of anxiety disorders in Pakistan is not known. There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders in the country. This is the first pilot study to address the prevalence of anxiety disorders and their association with sociodemographic factors in Pakistan.MethodsA cross-sectional study was conducted among people visiting Aga Khan University Hospital (AKUH), a tertiary care facility in Karachi, Pakistan. The point prevalence of anxiety amongst the sample population, which comprised of patients and their attendants, excluding all health care personnel, was assessed using the validated Urdu version of the Hospital Anxiety and Depression Scale (HADS). The questionnaire was administered to 423 people. Descriptive statistics were performed for mean scores and proportions.ResultsThe mean anxiety score of the population was 5.7 ± 3.86. About 28.3% had borderline or pathological anxiety. The factors found to be independently predicted with anxiety were, female sex (odds ratio (OR) = 2.14, 95% CI 1.36–3.36, p = 0.01); physical illness (OR = 1.67, 95% CI 1.06–2.64, p = 0.026); and psychiatric illness (OR = 1.176, 95% CI 1.0–3.1, p = 0.048). In the final multivariate model, female sex (adjusted odds ratio (AOR) = 2, 95% CI 1.28–3.22) and physical illness (AOR = 1.56, 95% CI 0.97–2.48) were found to be significant.ConclusionFurther studies via nationally representative surveys need to be undertaken to fully grasp the scope of this emerging public health issue in Pakistan.
Highlights
The developing world is faced with a high burden of anxiety disorders
The definition of General anxiety disorder (GAD) has changed over time and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition(DSM-4) takes persistent worry over 6 months along with three of the following six symptoms to be present: restlessness, fatigability, difficulty concentrating, irritability, muscle tension and sleep disturbance [3]
Anxiety disorders are common in the general population around the world [4]
Summary
The developing world is faced with a high burden of anxiety disorders. The exact prevalence of anxiety disorders in Pakistan is not known. There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders in the country This is the first pilot study to address the prevalence of anxiety disorders and their association with sociodemographic factors in Pakistan. The entity of general anxiety was originally conceptualized by Freud, who coined the term "anxiety neurosis" This included four major clinical syndromes: general irritability, chronic apprehension, anxiety attacks and secondary phobic avoidance [2]. Anxiety disorders are common in the general population around the world [4] They constitute a substantial proportion of the global burden of disease, and are projected to form the second most common cause of disability by 2020 [5]. The prevalence estimates are higher when compared with other developing countries, and are twice the figures reported from Uganda [9], Lesotho [10] and Zimbabwe [11]
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