Background
Methods and materials
Study setting and period
Participants
Measurements
Data collection procedures and instruments
Data processing, analysis, interpretation, and presentation
Ethical consideration
Results
Socio-demographic characteristics
Characteristics | Non depressed (PHQ-9 < 5) N (%) | Depressed (PHQ-9 ≥ 5) N (%) | Total (%) |
---|---|---|---|
Sex | |||
Male | 60 (44.8) | 74 (49.3) | 134 (47.2) |
Female | 74 (55.2) | 76 (50.7) | 150 (52.8) |
Age | |||
18–26 | 17 (12.7) | 17 (11.3) | 34 (12.0) |
27–35 | 15 (11.2) | 21 (14.0) | 36 (12.7) |
36–44 | 20 (14.9) | 13 (8.7) | 33 (11.6) |
45–53 | 22 (16.4) | 25 (16.7) | 47 (16.5) |
–62 ref | 28 (20.9) | 26 (17.3) | 54 (19.0) |
63–71 | 22 (16.4) | 28 (18.7) | 50 (17.6) |
≥ 72 | 10 (7.5) | 20 (13.3) | 30 (11.2) |
Marital status | |||
Single | 20 (14.9) | 13 (8.7) | 33 (11.6) |
Married | 105 (78.4) | 111 (74.0) | 216 (76.0) |
Divorced/separate | 4 (3.0) | 10 (6.7) | 14 (5.0) |
Widowed | 5 (3.7) | 16 (10.7) | 21 (7.4) |
Educational status | |||
Illiterate | 67 (5.0) | 84 (56.0) | 151 (53.2) |
Able to read and write only | 20 (14.9) | 36 (24.0) | 56 (19.7) |
Primary (1–8) | 28 (20.9) | 19 (12.7) | 47 (16.5) |
Secondary (9–12) | 14 (10.4) | 7 (4.7) | 21 (7.4) |
Tertiary (+12) | 5 (3.7) | 4 (2.7) | 9 (3.2) |
Occupational status | |||
Unemployed | 16 (11.9) | 35 (23.3) | 51 (18.0) |
Employed | 12 (9.0) | 4 (2.7) | 16 (5.6) |
Farmer | 70 (52.2) | 74 (49.3) | 144 (50.7) |
Merchant | 9 (6.7) | 10 (6.7) | 19 (6.7) |
Retired | 7 (5.2) | 5 (3.3) | 12 (4.2) |
Housewife | 11 (8.2) | 14 (9.3) | 25 (8.8) |
Other | 9 (6.7) | 8 (5.3) | 17 (6.0) |
Residence | |||
Rural areas | 80 (59.7) | 103 (68.7) | 183 (64.4) |
Urban areas | 54 (40.3) | 47 (31.3) | 101 (35.6) |
Average annual income | |||
0–999 | 33 (24.6) | 37 (24.7) | 70 (24.6) |
1000–3599 | 32 (23.9) | 37 (24.7) | 69 (24.3) |
3600–10,799 | 28 (20.9) | 43 (28.7) | 71 (25.0) |
≥ 10,800 | 41 (30.6) | 33 (22.0) | 74 (26.1) |
Psychosocial and behavioral factors
Characteristics | Non depressed N (%) | Depressed N (%) | Total N (%) |
---|---|---|---|
Living condition | |||
Alone | 6 (4.5) | 12 (8.0) | 18 (6.3) |
With family | 121 (90.3) | 136 (90.7) | 257 (90.5) |
Othera | 7 (5.2) | 2 (1.3) | 9 (3.2) |
Oslo 3-items social support scale | |||
Poor support | 38 (28.4) | 62 (41.3) | 100 (35.2) |
Moderate support | 62 (46.3) | 53 (35.3) | 115 (40.5) |
Strong support | 34 (25.4) | 35 (23.3) | 69 (24.3) |
Physical activity | |||
Yes | 79 (59.0) | 66 (44.0) | 145 (51.1) |
No | 55 (41.0) | 84 (56.0) | 139 (48.9) |
Life time used substances | |||
Cigarette | |||
Yes | 9 (6.7) | 17 (11.3) | 26 (9.2) |
No | 125 (93.3) | 133 (88.7) | 258 (90.8) |
Alcohol | |||
Yes | 19 (14.2) | 15 (10.0) | 34 (12.0) |
No | 115 (85.8) | 135 (90.0) | 250 (88.0) |
Khat | |||
Yes | 33 (24.6) | 43 (28.7) | 76 (26.8) |
No | 101 (75.4) | 107 (71.3) | 208 (73.2) |
Cannabis | |||
Yes | 4 (3.0) | 6 (4.0) | 10 (3.5) |
No | 130 (97.0) | 144 (96.0) | 274 (96.5) |
Current used substances | |||
Cigarette | |||
Yes | 3 (2.2) | 11 (7.3) | 14 (4.9) |
No | 131 (97.8) | 139 (92.7) | 270 (95.1) |
Alcohol | |||
Yes | 7 (5.2) | 11 (7.3) | 18 (6.3) |
No | 127 (94.8) | 139 (92.7) | 266 (93.7) |
Khat | |||
Yes | 14 (10.4) | 11 (7.3) | 25 (8.8) |
No | 120 (89.6) | 139 (92.7) | 259 (91.2) |
Cannabis | |||
Yes | 2 (1.5) | 3 (2.0) | 5 (1.8) |
No | 132 (98.5) | 147 (98.0) | 279 (98.2) |
Clinical characteristics and medication related factors
Medication related factors
Characteristics | Total N (%) | Nondepressed N (%) | Depressed N (%) |
---|---|---|---|
Medication | |||
Digoxin | 62 (21.8) | 33 (24.6) | 29 (19.3) |
Diuretic | 213 (75.0) | 97 (72.4) | 116 (77.3) |
Beta blocker | 137 (45.2) | 72 (53.7) | 65 (43.3) |
Angiotensin-converting enzyme inhibitor | 157 (55.3) | 72 (53.7) | 85 (56.7) |
Calcium channel blocker | 24 (8.5) | 9 (6.7) | 15 (10.0) |
Anticoagulant | 149 (52.5) | 70 (52.2) | 79 (52.7) |
Statine (lipid lowering agents) | 22 (7.7) | 11 (8.2) | 11 (7.3) |
Penicillin | 23 (8.1) | 10 (7.5) | 13 (8.7) |
Other? | 17 (6.0) | 8 (6.0 | 9 (6.0) |
Duration of treatment (year) | |||
≤ 1 | 91 (32.0) | 50 (37.3) | 41 (27.3) |
1–2 | 51 (18.0) | 24 (17.9) | 27 (18.0) |
2–3 | 29 (10.2) | 12 (9.0) | 17 (11.3) |
3–4 | 30 (10.6) | 11 (8.2) | 19 (12.7) |
≥ 5 | 83 (29.2) | 37 (27.6) | 46 (30.7) |
Medication adherence | |||
Non adherent | 78 (27.5) | 45 (30.0) | 33 (24.6) |
Adherent | 206 (72.5) | 105 (70.0) | 101 (75.4) |
Clinical related factors
Characteristics | Total N (%) | No depressed N % | Depressed N (%) |
---|---|---|---|
Diagnosis type of CVD illness | |||
Hypertensive heart diseases | 102 (35.9) | 48 (35.8) | 54 (36.0) |
Ischemic heart disease | 75 (26.4) | 37 (27.6) | 38 (25.3) |
Valvular heart disease | 35 (12.3) | 11 (8.2) | 24 (16.0) |
Rheumatic heart disease | 26 (9.2) | 14 (10.4) | 12 (8.0) |
Cardiomyopathy | 29 (10.2) | 16 (11.9) | 13 (8.7) |
Other | 17 (5.0) | 8 (6.0) | 9 (6.0) |
Duration of CVD illness (year) | |||
≤ 1 | 68 (23.9) | 36 (26.9) | 32 (21.3) |
1–3 | 78 (27.5) | 37 (27.6) | 41 (27.3) |
3–5 | 58 (20.4) | 26 (19.4) | 32 (21.3) |
5–7 | 35 (12.3) | 15 (11.2) | 20 (13.3) |
> 7 | 45 (15.8) | 20 (14.9) | 25 (16.7) |
Family history of mental illness | |||
Yes | 36 (12.7) | 16 (11.9) | 20 (13.3) |
No | 248 (87.3) | 118 (88.1) | 130 (86.7) |
Comorbid diabetes mellitus | |||
Yes | 14 (4.9) | 5 (3.7) | 9 (6.0) |
No | 270 (95.1) | 129 (96.3) | 141 (94.0) |
Duration of DM after onset of CVD illness (year) | |||
≤ 3 | 8 (72.7) | 3 (75.0) | 5 (71.4) |
> 3 | 3 (27.3) | 1 (25.0) | 2 (28.6) |
Comorbid hypertension | |||
Yes | 128 (45.1) | 59 (44.0) | 69 (46.0) |
No | 156 (54.9) | 75 (56.0) | 81 (54.0) |
Duration of HTN after onset of CVD illness (years) | |||
≤ 3 | 60 (63.8) | 27 (62.8) | 33 (64.7) |
> 3 | 34 (36.2) | 16 (37.2) | 18 (35.3) |
NYHA class | |||
I | 16 (7.1) | 6 (5.8) | 10 (8.3) |
II | 116 (51.8) | 54 (52.4) | 62 (51.2) |
III | 57 (25.4) | 27 (26.2) | 30 (24.8) |
IV | 35 (15.6) | 16 (15.5) | 19 (15.7) |
Lipid profile level | |||
Total cholesterol (mg/dl) | |||
< 200 | 18 (78.3) | 7 (63.6) | 11 (91.7) |
≥ 200 | 5 (21.7) | 4 (36.4) | 1 (8.3) |
Low density lipoprotein (mg/dl) | |||
< 40 | 9 (36.0) | 4 (36.4) | 5 (35.7) |
≥ 40 | 16 (64.0) | 7 (63.6) | 9 (64.3) |
Triglycerides (mg/dl) | |||
< 150 | 10 (45.5) | 4 (40.0) | 6 (50.0) |
≥ 150 | 12 (54.5) | 6 (60.0) | 6 (50.0) |
New York Heart Association classification among CVD patients and its association with depression
Lipid profile among CVD patients and its association to depression
Prevalence of depression
Factors associated with depression in bivariate analysis among adult CVD patients
Characteristics | Non depressed N (%) | Depressed N (%) | COR (95% CI) | P-value |
---|---|---|---|---|
Age | ||||
18–26 | 17 (12.7) | 17 (11.3) | 1.077 (.456, 2.541) | .866 |
27–35 | 15 (11.2) | 21 (14.0) | 1.508 (.644, 3.531) | .344 |
36–44 | 20 (14.9) | 13 (8.7) | .700 (.291, 1.686) | .426 |
45–53 | 22 (16.4) | 25 (16.7) | 1.224 (.559, 2.678) | .613 |
54–62 | 28 (20.9) | 26 (17.3) | 1 | |
63–71 | 22 (16.4) | 28 (18.7) | 1.371 (.633, 2.968) | .424 |
≥ 72 | 10 (7.5) | 20 (13.3) | 2.154 (.852, 5.448) | .105a |
Marital status | ||||
Single | 20 (14.9) | 13 (8.7) | .615 (.291, 1.298) | .202a |
Married | 105 (78.4) | 111 (74.0) | 1 | |
Divorced/separate | 4 (3.0) | 10 (6.7) | 2.365 (.720, 7.772) | .156a |
Widowed | 5 (3.7) | 16 (10.7) | 3.027 (1.071, 8.556) | .037a |
Educational status | ||||
Illiterate | 67 (50.0) | 84 (56.0) | 1 | |
Able to read and write only | 20 (14.9) | 36 (24.0) | 1.436 (.762, 2.706) | .263 |
Primary (1–8) | 28 (20.9) | 19 (12.7) | .541 (.278, 1.053) | .070a |
Secondary (9–12) | 14 (10.4) | 7 (4.7) | .399 (.152, 1.044) | .061a |
Tertiary (+12) | 5 (3.7) | 4 (2.7) | .638 (.165, 2.470) | .515 |
Employment status | ||||
Unemployed | 16 (11.9) | 35 (23.3) | 2.069 (1.053, 4.067) | .035a |
Employed | 12 (9.0) | 4 (2.7) | .315 (.097, 1.024) | .055a |
Farmer | 70 (52.2) | 74 (49.3) | 1 | |
Merchant | 9 (6.7) | 10 (6.7) | 1.051 (.403, 2.740) | 919 |
Retired | 7 (5.2) | 5 (3.3) | .676 (.205, 2.228) | .52 |
Housewife | 11 (8.2) | 14 (9.3) | 1.204 (.512, 2.830) | .67 |
Other | 9 (6.7) | 8 (5.3) | .841 (.307, 2.301) | .736 |
Residence | ||||
Rural areas | 80 (59.7) | 103 (68.7) | 1 | |
Urban areas | 54 (40.3) | 47 (31.3) | .676 (.415, 1.101) | .116a |
Average annual income | ||||
0–999 | 33 (24.6) | 37 (24.7) | 1.393 (.723, 2.684) | .322 |
1000–3599 | 32 (23.9) | 37 (24.7) | 1.437 (.743, 2.776) | .281 |
3600–10,799 | 28 (20.9) | 43 (28.7) | 1.908 (.985, 3.694) | .055a |
≥ 10,800 | 41 (30.6) | 33 (22.0) | 1 |
Characteristics | Non depressed N (%) | Depressed N (%) | COR (95% CI) | P-value |
---|---|---|---|---|
Living condition | ||||
Alone | 6 (4.5) | 12 (8.0) | 1.779 (.648, 4.886) | .263 |
With family | 121 (90.3) | 136 (90.7) | 1 | |
Othera | 7 (5.2) | 2 (1.3) | .254 (.052, 1.247) | .091b |
Oslo 3-items social support scale | ||||
Poor support | 38 (28.4) | 62 (41.3) | 1.909 (1.106, 3.293) | .020b |
Moderate support | 62 (46.3) | 53 (35.3) | 1 | |
Strong support | 34 (25.4) | 35 (23.3) | 1.204 (.662, 2.189) | .542 |
Physical activity | ||||
Yes | 79 (59.0) | 66 (44.0) | .547 (.341, .877) | .012b |
No | 55 (41.0) | 84 (56.0) | 1 | |
Cigarette current user | ||||
Yes | 3 (2.2) | 11 (7.3) | 3.456 (.943, 12.664) | .061b |
No | 131 (97.8) | 139 (92.7) | 1 |
Characteristics | Non depressed N (%) | Depressed N (%) | COR (95% CI) | P-value |
---|---|---|---|---|
Diagnosis type of CVD illness | ||||
Hypertensive heart diseases | 102 (35.9) | 48 (35.8) | 1 | |
Ischemic heart disease | 75 (26.4) | 37 (27.6) | .913 (.503, 1.658) | .765 |
Valvular heart disease | 35 (12.3) | 11 (8.2) | 1.939 (.86, 4.371) | .110a |
Rheumatic heart disease | 26 (9.2) | 14 (10.4) | .762 (.321, 1.807) | .537 |
Cardiomyopathy | 29 (10.2) | 16 (11.9) | .722 (.315, 1.654) | .442 |
Other | 17 (5.0) | 8 (6.0) | 1.000 (.357, 2.797) | 1.00 |
Age onset of CVD | ||||
9–19 | 11 (8.2) | 12 (8.0) | .679 (.264, 1.745) | .421 |
20–29 | 17 (12.7) | 21 (14.0) | .769 (.347, 1.701) | .516 |
30–39 | 24 (17.9) | 19 (12.7) | .493 (229, 1.058) | .070a |
40–49 | 24 (17.9) | 27 (18.0) | .700 (.339, 1.445) | .335 |
50–59 | 30 (22.4) | 26 (17.3) | .539 (.266, 1.092) | .086a |
≥ 60 | 28 (20.9) | 45 (30.0) | 1 | 1 |
Medication | ||||
B-blocker | 72 (53.7) | 65 (43.3) | 1.519 (.950, 2.426) | .081a |
Duration of treatment (year) | ||||
≤ 1 | 91 (32.0) | 50 (37.3) | 1 | |
1–2 | 51 (18.0) | 24 (17.9) | 1.372 (.69, 2.729) | .367 |
2–3 | 29 (10.2) | 12 (9.0) | 1.728 (.741, 4.028) | .206a |
3–4 | 30 (10.6) | 11 (8.2) | 2.106 (.901, 4.927) | .086a |
≥ 5 | 83 (29.2) | 37 (27.6) | 1.516 (.834, 2.758) | .173a |
Lipid profile level—total cholesterol (mg/dl) | ||||
< 200 | 7 (63.6) | 11 (91.7) | 4.488 (.495, 40.69) | .182a |
≥ 200 | 4 (36.4) | 1 (8.3) | 1 |
Factors associated with depression in multiple logistic regression among patients with CVD
Characteristics | Non depression N (%) | Depression N (%) | AOR (95% CI) | P-value |
---|---|---|---|---|
Occupational status | ||||
Unemployed | 16 (11.9) | 35 (23.3) | 2.248 (1.102, 4.583)a | .026 |
Employed | 12 (9.0) | 4 (2.7) | .252 (.073, .869)a | .029 |
Farmer | 70 (52.2) | 74 (49.3) | 1 | |
Merchant | 9 (6.7) | 10 (6.7) | .904 (.326, 2.510) | .847 |
Retired | 7 (5.2) | 5 (3.3) | .723 (.212, 2.472) | .605 |
Housewife | 11 (8.2) | 14 (9.3) | 1.417 (.587, 3.419) | .438 |
Other | 9 (6.7) | 8 (5.3) | .635 (.224, 1.805) | .395 |
Oslo 3-items social support scale | ||||
Poor support | 38 (28.4) | 62 (41.3) | 2.324 (1.290, 4.187)a | .005 |
Moderate support | 62 (46.3) | 53 (35.3) | 1 | |
Strong support | 34 (25.4) | 35 (23.3) | 1.336 (.702, 2.545) | .378 |
Current cigarette user | ||||
Yes | 3 (2.2) | 11 (7.3) | 4.722 (1.218, 18.311)a | .025 |
No | 131 (97.8) | 139 (92.7) | 1 | |
Physical activity | ||||
Yes | 79 (59.0) | 66 (44.0) | .541 (.328,.893)a | .016 |
No | 55 (41.0) | 84 (56.0) | 1 |