Anxiety and depression is a major public health issue globally and will be the second foremost cause of disability by 2020. Globally, fifty percent of the population with anxiety and depression has multimorbidity. the prevalence of anxiety and depression associated with multimorbidity leads to higher health care expenditure and worsening of mental and physical health outcomes.
To determine the prevalence of anxiety and depressive symptoms among adults in Karachi, Pakistan.
To examine the association between multimorbidity and socio-demographic factors with anxiety and depressive symptoms among adults in Karachi, Pakistan.
An analytical cross-sectional study was conducted among all the adults who were aged 30 years and above in Karachi, Pakistan. Systematic random sampling was employed to recruit a sample of 3250 participants. A structured questionnaire was developed to collect information about all the potential risk factors. Anxiety and depressive symptoms were measured using Aga Khan University Anxiety Depression Scale (AKUADS) using cutoff > 20 scores and above. Binary logistic regression was performed to calculate and report crude and adjusted odds ratios and their 95% confidence intervals. A P-value of ˂ 0.05 was considered as significant.
The prevalence of anxiety and depressive symptoms were reported as 27.4% among 2867 participants. The current study has shown that more than half of the population with multimorbidity had anxiety and depressive symptoms.. We adjusted for all variables included in multivariate analysis by using cutoff of p-value <0.05. The final multivariate logistic regression revealed that the presence of multimorbidity (AOR=1.34, 95% CI, 1.13, 1.59), gender (AOR= 2.41, 95% CI, 1.99, 2.91), number of children (AOR=0.68, 95% CI, 0.55, 0.83), ethnicity (AOR=1.69, 95% CI, 1.18, 2.42), illiteracy (AOR=1.59, 95% CI: 1.15, 2.21), occupation (AOR=1.41, 95% CI, 1.03, 1.95) and visiting a faith healer (AOR=2.34, 95% CI: 1.86, 2.95) were the predictors of anxiety and depressive symptoms.
This study showed a high burden of anxiety and depressive symptoms among adults 30 years and above in Karachi, Pakistan. The prevalence of anxiety and depressive symptoms were two folds greater among females as compared to males. Moreover, the present study also highlighted that the magnitude of anxiety and depressive symptoms was particularly alarming among females with physical multimorbidity.