The Association between Hypertension and Depression and Anxiety Disorders: Results from a Nationally-Representative Sample of South African Adults |
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Authors: | Anna Grimsrud Dan J. Stein Soraya Seedat David Williams Landon Myer |
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Affiliation: | 1. School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.; 2. Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.; 3. Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa.; 4. Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, United States of America.;London School of Hygiene and Tropical Medicine, Peru |
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Abstract: | ObjectiveGrowing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa.MethodsData come from a nationally-representative survey of adults (n = 4351). The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions.ResultsOverall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR) = 1.55, 95% Confidence interval (CI) = 1.10–2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05), while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46–3.45), but not 12-month depressive disorders or comorbid anxiety-depression.ConclusionsThese are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders. |
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