Depressive symptoms in people with chronic physical conditions: prevalence and risk factors in a Hong Kong community sample

Abstract

BackgroundDepression is predicted to become one of the two most burdensome diseases worldwide by 2020 and is common in people with chronic physical conditions. However, depression is relatively uncommon in Asia. Family support is an important Asian cultural value that we hypothesized could protect people with chronic physical conditions from developing depression. We investigated depressive symptom prevalence and risk factors in a Chinese sample with chronic medical conditions, focusing on the possible protective role of family relationships.MethodsData were obtained from the Hong Kong Jockey Club FAMILY Project cohort study in 2009–2011, which included 6,195 participants (age ≥15) with self-reported chronic conditions. Depressive symptoms were recorded using the Patient Health Questionnaire-9 (PHQ-9). Demographic and lifestyle variables, stressful life events, perceived family support and neighborhood cohesion were assessed. Factors associated with a non-somatic (PHQ-6) depression score were also examined.ResultsThe prevalence of depressive symptoms (PHQ-9 scores ≥5) was 17% in those with one or more chronic conditions, and was more prevalent in women than in men (19.7% vs. 13.9%; p < 0.001). In multilevel analyses, life stress, number of chronic conditions and satisfaction with family support explained 43% of the variance in PHQ-9 scores (standardized regression coefficients of 0.46, 0.15, and −0.12 respectively, all p <0.001). Body mass index, problem alcohol drinking, physical activity, and unmarried status were significantly associated with PHQ-9 scores, although these associations were weak. Variables associated with depression explained 35% of the variance in non-somatic (PHQ-6) depression scores. Satisfaction with family support played a stronger protective role against depressive symptoms (both PHQ-9 and PHQ-6 scores) among women than men (p < 0.05).ConclusionsAcute life stress and the number of chronic conditions, together with socio-demographic factors, explain most variance in depressive symptoms among chronically ill Chinese individuals. Somatic items in the PHQ-9 increased the depression scores but they did not alter the pattern of predictors. Family support appears to be an important protective factor in Chinese cultures for individuals with chronic conditions.

A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes

“…Data were collected in a longitudinal way starting from the first antenatal visit and screening visit for GDM at primary hospitals, and visits at the TWCHC GDM clinic and at postpartum. The patient health questionnaire (PHQ)-9 was a validated tool to detect depression in general and diabetic Chinese populations in Hong Kong [ 22 - 24 ] which was also administered at 34 th gestational week. Physical activity was collected with a validated questionnaire in 2002 China National Nutrition and Health Survey [ 25 ] at 34 th gestational week.…”

Effects of Depressive Symptoms and Family Satisfaction on Health Related Quality of Life: The Hong Kong FAMILY Study

“…Details of sampling and interview have been described elsewhere [23]. In brief, sampling was based on residential addresses provided by the Hong Kong Census and Statistics Department.…”

Metabolic syndrome and depressive symptoms among rural Northeast general population in China

“…Two national surveys of mental disorders, conducted in 1982 and 1993, revealed very low, but increasing, lifetime prevalence (0.46 and 0.83%) of affecting disorders in China [2, 3]. Study conducted in Hong Kong claimed that the prevalence of depressive symptom was 17% in those with one or more chronic conditions, and was more prevalent in women than in men (19.7% vs. 13.9%) [4]. In addition to some conventional associations between depressive symptoms and older age, female gender, low education, cognitive impairment, living alone and history of chronic diseases [2, 3], resent studies claimed that depressive symptoms might be associated with metabolic syndrome (MetS) [5, 6].…”