Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia

Abstract

Introduction: Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic. Methods: This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses. Results: The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91-0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32-10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18-8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49-21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01-1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33-19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70-15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03-20.7). Conclusion: Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it.

Depression and anxiety among individuals with medical conditions during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh

“…Smoking was associated with depression and anxiety, similar to prior findings among people with diabetes ( Katon et al, 2004 ; Saleh et al, 2014 ) and those with obesity and chronic illnesses ( Hassan et al, 2019 ). Smoking increases the likelihood of many diseases and may cause serious health problems, including cardiovascular diseases ( Siddiqi et al, 2015 ) and cancers ( Lee, 2011 ).…”

“…A study conducted in Ethiopia found the prevalence of anxiety to be higher among individuals with hypertension ( Aberha et al, 2016 ). A study in Malaysia demonstrated a high prevalence of depression and anxiety among obese individuals with chronic medical illnesses ( Hassan et al, 2019 ), consistent with the findings of this current study but seemingly inconsistent with an earlier study in Bangladesh ( Moonajilin et al, 2020 ). In line with the current study, depression and anxiety were found to be elevated in individuals with heart failure in prior studies ( AbuRuz, 2018 ; Konstam et al, 2005 ).…”

Psychological Distress Screening for Depression, Anxiety and Stress among Medical Ward Patients in Hospital Tapah, Malaysia: A Cross-Sectional Study Using The Depression, Anxiety and Stress Scale (DASS-21)

“…17 Other studies have suggested that unemployed persons had feelings of instability and financial constraint, which could contribute to PD. 17,27 A significant association between smoking and anxiety was found in our study, as non-smokers had a higher risk of feeling anxiety. Morissette possible correlation between smoking and the expectation of reduction in anxiety symptoms.…”

“…28 However, this study's findings were inconsistent with other studies in which smokers had more anxiety symptoms. 27,29 According to the Mental Health Foundation, nicotine brings an immediate relaxation and allows smokers to have a misconception about nicotine. However, this short-term feeling might lead the smokers to withdrawal symptoms and increased cravings.…”

An analysis of parents’ perceived stress and the parent-child relationship during the COVID-19 pandemic

“…Although the "social isolation" or "stay home" restrictions have been effective in preventing the spread of the virus, they also have negative economic, social, and health-related effects. 1,2 The literature reports mental problems related to quarantine restrictions implemented during such pandemics, such as anxiety, depression symptoms, impaired sleep quality, 3 During this process, serious measures have been and are still taken to prevent the increasing infection in Turkey. On March 13, 2020, the Ministry of Interior sent a "Lockdown Circular" to all Governorships within the scope of the fight against COVID-19 pandemic.…”