Multimorbidity is associated with more subsequent depressive symptoms in three months: a prospective study of community-dwelling adults in Hong Kong

Abstract

Multimorbid adults are more likely to have depression. However, existing data are mostly cross-sectional or retrospective with poor control of baseline depressive symptoms and a focus on long-term effects. This prospective study examined the short-term independent predictive association of multimorbidity with depressive symptoms. We collected baseline and three-month follow-up data from a population-based sample of 300 community-dwellers (aged 18–77) in Hong Kong. Multiple regression was used to examine the predictive association of baseline multimorbidity (two or more physical chronic conditions), relative to having one or zero conditions, with depressive symptoms in three months measured by the Center for Epidemiological Studies-Depression (CES-D, out of 60) scale. Multivariable adjustments were made for socio-demographics, baseline CES-D scores, and baseline self-perceived physical health status. A sub-analysis was conducted to compare multimorbid participants with monomorbid (one condition) ones. In our sample, 48 participants (16%) had multimorbidity. Adjusted analysis showed that on average, multimorbid participants had 2.71 (95% CI, 0.36–5.06, Cohen’s d = 0.128) more points in the CES-D scale at three-month follow-up than non-multimorbid participants (zero or one condition) did, which was independent of baseline CES-D scores, self-perceived physical health status, and socio-demographics. Compared with monomorbid participants, multimorbidity was associated with a similar difference of 2.92 (95% CI, 0.81–5.66, Cohen’s d = 0.220) points. Incremental R-square changes associated with the inclusion of multimorbidity were significant (P < 0.05). In conclusion, the effect of multimorbidity on depressive symptoms may take a shorter period to manifest than previously assumed. The mental health of adults with multimorbidity warrants more attention.

Associations between physical multimorbidity patterns and common mental health disorders in middle-aged adults: A prospective analysis using data from the UK Biobank

“…The observed associations we describe between physical multimorbidity status and future incident depression corroborate the prospective findings of previous studies [ 10 , 11 , 13 , [40] , [41] , [42] ], particularly those studies that report a dose-response relationship [19] . However, to the best of our knowledge, this is the first study to show that physical multimorbidity can lead to future anxiety specifically.…”

Association Between Multiple Chronic Conditions and Depressive Symptoms Among Older Adults in China: Evidence From the China Health and Retirement Longitudinal Study (CHARLS)

“…The risk of depression, a psychiatric disorder that is related to physical health, is significantly related to the number of chronic diseases of an individual, thus the risk of depression increases with the number of chronic diseases. Hua's study found that older adults with multiple chronic diseases (MCCs) often have different degrees of depressive symptoms (9)(10)(11)(12). Presently, MCCs and health loss due to MCCs among older adults in China are gradually increasing (13,14).…”

Comparing Multimorbidity Patterns Among Discharged Middle-Aged and Older Inpatients Between Hong Kong and Zurich: A Hierarchical Agglomerative Clustering Analysis of Routine Hospital Records

“…Multimorbidity is commonly referred to as the co-occurrence of two or more chronic health conditions ( 1 ) and is consistently associated with poorer quality of life ( 2 ), more healthcare utilization ( 3 ), deteriorating mental health ( 4 ), and greater risk of mortality ( 5 ). Various models of care have been proposed and trialed to address this complexity in clinical practices ( 6 , 7 ).…”