Depression and Generalized Anxiety disorders among Chronically Ill Middle and Older Adults in Saudi Arabia

BACKGROUND: Depression and anxiety are common prevalent in patients with chronic disease, and Chronic illness are long-lasting conditions with persistent effects and complications. Depression and anxiety disorders are well known to have a negative but significant impact on the course, outcomes, long-term survival, and treatment efficacy of patients suffering from physical disease. Given the high prevalence and potential negative consequences of this type of comorbidity in elderly patients, there is an urgent need for this study to be conducted due to the scarcity of statistics on the topic among middle and older adults in the Al-Qassim region. On the other hand, early identification of people who are more likely to experience psychological distress is critical in prevention and management strategies.

OBJECTIVES: To assess the severity of depression and anxiety, using validated self-report measures of middle-aged and older adults; and to determine the association between anxiety and depression levels and socio-demographic characteristics.

METHODS: In February 2021 and for two months, a cross-sectional study of middle- aged and older adults from Al-Shifa hospital at Al-Qassim region was conducted with questionnaires on socio-demographic and clinical characteristics, and validated Generalized Anxiety Disorders (GAD-7), and Patient Health Questionnaire (PHQ-9) anxiety and depression questionnaires. Two hundreds middle- aged and older adults participants of Al-Shifa Hospital participated in this study and agreed to complete the questionnaire.

RESULTS: 79% (n=158) of participants had minimal to mild depression and 21% (n=42) had moderate-to-severe depression; the average PHQ-9 score was 7.05 (M =7.05; SD=4.4), while 81.5% (n=163) of participants had minimal to mild anxiety and 18.5% (n=37) had moderate-to-severe anxiety; the average GAD score was 6.6 (M =6.6; SD =4.3). The significant predictors of moderate-to-severe depression in the logistic regression analysis were: male sex (odds ratio (OR):0.0.272; confidence interval (CI):0.101-0.730) and psychiatric disorders (odds ratio (OR):13.131; confidence interval (CI):2.975-57.949). The significant predictors of moderate-to-severe anxiety in the logistic regression analysis were psychiatric disorders (odds ratio (OR):13.080; confidence interval (CI):3.261-52.464). There was a strong significant positive correlation between PHQ-9 score and GAD score.

CONCLUSION: The study group had higher prevalence of moderate and severe depression, which was significantly associated with female sex and psychiatric disorders; while the prevalence of moderate and severe anxiety was significantly associated with the presence of psychiatric disorders. Our findings reaffirm the importance of providing appropriate specialized interventions to promote the mental health of chronically ill elderly, with a focus on high-risk groups.