Factors associated with depression and generalized anxiety disorder among adults living with diabetes and hypertension comorbidity in Chirirbandar, Bangladesh: a cross-sectional study

Abstract

Introduction: Coexistence of non-communicable diseases like diabetes and hypertension increases the risk of common mental health conditions such as depression and generalized anxiety disorder (GAD). Mental health is underexplored in general population of Bangladesh let alone among population with diabetes and hypertension comorbidity. This study aims to assess the prevalence of depression and GAD and explore the associated factors among adults with diabetes and hypertension comorbidity in Chirirbandar, Bangladesh. Method: A cross-sectional study was conducted from November 21, 2024 to December 10, 2024 in Chirirbandar, Dinajpur. Data from 387 adults diagnosed with both diabetes and hypertension were included in the final analysis. Data were collected using a pre-tested structured questionnaire, incorporating GAD-7 and PHQ-9 scales to screen GAD and depression respectively. Multivariable logistic regression was used to explore the factors associated with GAD and depression. Results: The prevalence of depression was 17.83%. Factors singnificantly associated with depression included marital status and wealth index. Higher odds of depression among participants with controlled hypertension (aOR =3.65, 95%CI: 1.70-7.81, p=0.001) was observed. The prevalence of GAD was 7.24%. Education level, sedentary time spent per day, and kitchen location were found to be associated with GAD. Behavioral factors, such as tobacco use, fruits and vegetable intake, physical activity were not significantly associated with either condition. Conclusion: A high prevalence of depression and GAD were observed among the adults with diabetes and hypertension comorbidity. The findings from the study emphasize the need to integrate mental health services into the existing non-communicable disease care, with particular attention to socio-demographic, behavioural and environmental factors. Further research is required to establish prospective associations in people with hypertension and diabetes comorbidity and develop targeted interventions in Bangladesh.