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Prevalence of Undiagnosed Depression among Persons with Hypertension and Associated Risk Factors: A Cross-Sectional Study in Urban Nepal
Authors:Dinesh Neupane  Bindu Panthi  Craig S. McLachlan  Shiva Raj Mishra  Brandon A. Kohrt  Per Kallestrup
Affiliation:1Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark;2Nobel College, Faculty of Science and Technology, Kathmandu, Nepal;3Rural Clinical School, University of New South Wales, Sydney, Australia;4Shiva Raj Mishra, Nepal Development Society, Kathmandu, Nepal;5Brandon A. Kohrt, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America;University of Tolima, COLOMBIA
Abstract:BackgroundDespite an increasing number of studies exploring prevalence of depression among hypertensive patients in high income countries, limited data is available from low and middle income countries, particularly Nepal. Our aim was to investigate the prevalence of undiagnosed (sub clinical) depression and associated risk factors among hypertensive patients attending a tertiary health care clinic in Nepal.MethodsThe study was based on a cross-sectional study design, with 321 hypertensive patients attending the Out-Patient Department of a central hospital in Nepal. Blood measure was recorded via a mercury column sphygmomanometer. Depression levels were assessed using the Beck Depression Inventory-Ia (BDI) scale. Demographics and risk factors were assessed.ResultThe proportion of participants with undiagnosed depression was 15%. Multivariable analyses demonstrated an increase in BDI scores with increased aging. Approximately a 1 point increase in the BDI score was observed for each additional decade of aging in hypertensive patients. Additional factors associated with increased risk of depression included being female (4.28 point BDI score increase), smoking (5.61 point BDI score increase), being hypertensive with no hypertensive medication (4.46 point BDI score increase) and being illiterate (4.46 point BDI score increase).ConclusionsAmong persons with hypertension in outpatient settings in Nepal, demographic (age, sex, education), behavioural (smoking,) and adherence factors (anti-hypertensive medication) were associated with undiagnosed depression. Screening programs in Nepal may assist early intervention in hypertensive patients with sub clinical depression.
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