Poor psychosocial status and cardiovascular risk factors are associated with depression or anxiety

Abstract Background Depression and anxiety are rising in South Africa but their associations with psychosocial and cardiovascular risk factors (CVRFs) remain under explored. This study determined the associations of depression and anxiety traits with poor psychosocial wellbeing, risky lifestyle behaviours and cardiometabolic diseases. Methods In a population-based cross-sectional study, data were collected via administered questionnaires, clinical examinations and biochemical assessments. Depression and anxiety traits were ascertained via the Patient Health Questionnaire-9 and Generalised Anxiety Disorder screening questions. Multivariable logistic regressions determined the associations with depression and anxiety traits; the basic model comprised sociodemographic factors, physical inactivity, tobacco smoking and alcohol misuse (CAGE ≥2). Psychosocial and cardiometabolic variables were entered individually in separate models. Results Among 678 participants, median age 52 years and mainly women (81%), prevalence of depression scores ≥10 were 14.2% (men:12.7%, women:14.6%, p = 0.498) and anxiety scores ≥10 were 10.2% (men:10.3%, women:10.2%). In the basic regression models, depression, but not anxiety, was associated with being separated, living as married/widowed vs. single (OR:2.01, 95%CI:1.02-3.94), and alcohol misuse (2.07, 1.13-3.78). Depression and anxiety were associated with decreasing social support (depression: 1.09, 1.04-1.12; anxiety: 1.09, 1.04-1.14), and increasing number of adverse life events. Hypertension (1.76, 1.07-2.90, p = 0.025), diabetes (1.98, 1.03-3.82, p = 0.041) and dyslipidaemia (1.97, 1.01-3.85, p = 0.048) were associated with depression but not anxiety. Conclusions The high burden and associations of depression and anxiety traits with poor psychosocial wellbeing suggest a need for holistic care approaches. The associations of depression traits with CVRFs warrant screening and care of depression in the presence of cardiometabolic diseases and alcohol misuse. Key messages • The high burden of depression and anxiety traits in South Africa is associated with poor social support and quality of life, and increasing adverse life events experienced. • The associations of depression traits with hypertension, diabetes, dyslipidaemia, and alcohol misuse highlight the need for integrated management strategies.