Prevalence of anxiety and depressive symptoms among in patients with heart failure at Jakaya Kikwete Cardiac Institute (JKCI), Dar es salaam.

Abstract

Abstract. Background: Heart failure is considered a major public health problem worldwide, and the common risk factor for depression and anxiety. Several studies have acknowledged these as the commonest mental disorders which are often undiagnosed and untreated. According to WHO (2015), Depression is the single largest contributor to global disability affecting 7.5% people, and anxiety ranked 6th affecting 3.4% of people globally.

Objectives: The objective of this study was to determine the prevalence of anxiety and depressive symptoms among inpatient with heart failure at Jakaya Kikwete Cardiac Institute, Dar es Salaam.

Materials and methods: This was a cross-sectional hospital-based study involving 272 sampled patients with Heart failure admitted at Jakaya Kikwete Cardiac Institute. Anxiety and depressive symptoms were assessed using Hopkins Symptom Checklist–25 (HSCL-25). Data on demographics, clinical symptoms and medical characteristics were collected via structured questionnaire. The data was analyzed by the SPSS software version 20.0. The study duration was from July 2018 – January 2019.

Results: Among 272 patients, 57.0% were female and the mean age all patients were SD 58±1.116 years. 59.5% Females had anxiety symptoms and 85 females (54.8%) with depressive symptoms. Participants with anxiety and depressive symptoms were 40 (14.7%). Prevalence of anxiety symptoms was 133 (48.9%) and prevalence of depressive symptoms was 99 (36.4%). The multivariate regression analysis showed that the New York Heart Association (NYHA) 4 (AOR 4.54, 95% C.I. 1.959-10.518), Marital status (AOR 5.34, 95% C.I. 2.255-12.633), Unemployment (AOR 3.90, 95% C.I. 1.110-13.734 ), Difficulty in breathing/ Dyspnea (AOR 3.97,95% C.I 1.412-11.160), Diabetes (AOR 11.58, 95% C.I 4.695-28.569), HIV (AOR 6.67, 95% C.I 2.639-16.853) and chronic pain due to bone/joint pain (AOR 6.38, 95% C.I 1.681-24.210) were independently associated with anxiety symptoms in patient with heart failure. High BMI (AOR 3.93, 95% C.I. 1.208-12.808), Marital status (AOR 8.75, 95% C.I. 2.491-30.755), Diabetes (AOR 44.74, 95% C.I.11.869-168.673), HIV (AOR 31.04, 95% C.I. 7.834-122.960) were independently associated with depressive symptoms in patient with Heart failure

Conclusions: The prevalence of anxiety and depressive symptoms was found to be high in this study population. The high body mass index (BMI), Marital status, Unemployed, Difficulty in breathing/ Dyspnea, Diabetes, HIV and chronic pain due to bone/joint pain were independent factors associated with anxiety and depressive symptoms among patients with Heart failure admitted at Jakaya Kikwete Cardiac Institute.

Keywords: Heart Failure, Anxiety and depressive symptoms