Relation between depression and chronic physical disease and healthcare utilisation in the Portuguese

Abstract

Abstract Background Previous studies show high chronic physical disease/depression comorbidity and higher healthcare use in these patients. Most studies focus on a single physical disease and do not consider number of diseases or depression severity. We aimed to characterise the chronic physical disease/depression relation in the Portuguese and analyse its association with healthcare use. Methods We undertook a cross-sectional study, using data (2019/2020) from an existing family panel (Em Casa Observamos Saúde), with “chronic physical disease” as exposure and “depression” and “healthcare use need” as outcomes. The sociodemographic characteristics of the sample were described. Logistic and multinomial regression analysis between depression (presence/severity) and chronic physical disease (presence/type/number) and between this comorbidity and healthcare use need were conducted. Adjusted odds ratio (OR) and 95% confidence intervals (CI95%) were calculated for each analysis. Analyses were weighted to account for complex sample design. Results 1068 individuals were included. In the population, 8.9% had depression and 72.1% had chronic physical disease. There was no statistically significant relation between general physical disease and depression (OR = 1.68 [CI95%:0.55;5.15]), but there was between allergy (OR = 2.08 [CI95%:1.02;4.25]) and COPD (OR = 3.04 [CI95%:1.21;7.61]). The risk of depression was smaller in those with two physical diseases (vs. three or more, OR = 0.32 [CI95%:0.15;0.68]). A relation between chronic physical disease and depression with healthcare use need was not observed with wide confidence intervals. Conclusions This study suggests a relation between COPD, allergy and a higher number of physical diseases and depression in the Portuguese. No evidence of an increased need for healthcare services was identified. Clinicians should be aware of this relation and more research needs to be conducted after the pandemic context. Key messages Depression is common in patients with physical diseases and should be treated. Improving coordination between services should be prioritised. No evidence of an increased need for healthcare services was identified but research outside the pandemic context should be pursued.