Prevalence of anxiety and depression among patients hospitalised with acute febrile illness

Introduction: Acute febrile illnesses (AFI) such as dengue, leptospirosis, and influenza result in large numbers of hospitalisation in the tropics. These illnesses may negatively impact patients’ mental health. The prevalence of anxiety and depression and risk factors associated with these conditions were evaluated in patients hospitalised with AFI. Methods: From July- October 2017, a cross-sectional study was conducted on consecutive patients ≥12 years of age admitted with AFI to a tertiary care hospital in Sri Lanka. The validated Sinhala translation of Hospital Anxiety and Depression Scale (HADS) was administered to identify the presence and severity of anxiety and depression. The prevalence of anxiety and depression was identified and the association with sociodemographic and clinical characteristics was determined using Chi square and t-tests and multivariable logistic regression. Results: Of 193 enrolled, 44.6% were male. AFI included dengue (62.7%), viral fever (10.4%), urinary tract infection (6.2%), leptospirosis (4.7%), pneumonia (3.1%) and typhus (0.5%). Overall, 41.4% patients had anxiety and 42.5% had depression. On multivariable analysis, anxiety was associated with awareness of diagnosis (OR=4.3, CI 1.3-13.76, p=.03), lower satisfaction score (OR=0.73, CI 0.58-0.92, p=0.008) and lower income (OR=1.92, CI 1.03-3.57, p=0.03). Depression was associated with anorexia (OR=2.8, CI 1.33-5.87, p=0.006) and diarrhoea (OR=2.29, CI 1.17-4.47, p=0.01).Conclusions: Patients hospitalised with AFI had a high prevalence of anxiety and depression. Gastrointestinal symptoms, lower socioeconomic status, and awareness of diagnosis of illness were all associated with anxiety. Our findings may be helpful in developing interventions to counteract anxiety and depression among patients hospitalised with AFI.