BACKGROUND: Research studies have provided evidence of a strong link between depressive disorder and the etiology, course and management of chronic conditions (Chapman, 2005). Despite the growing recognition of the importance of both chronic disease and depressive disorders to the health of individuals and communities, state public health programs have not commonly integrated mental health issues into chronic disease‐related interventions (Giles and Collins, 2010). Persons with depression are less likely to adhere to recommended lifestyle and behavioral changes. Data on association between depression and chronic diseases is of utmost relevance to provide valuable insight into reduction and management of chronic disease burden (Chapman, 2005). This study will examine the burden of depressive disorder by selected socio demographic characteristics and the association among depressive disorder and other chronic diseases among Delawareans.
METHODS: Data from 22,122 Delaware adults surveyed during 2011 through 2015 combined were analyzed to assess prevalence of depressive disorder in various population subgroups. Further, adjusted logistic regression analyses (multiple models) to examine the odds of 14 selected chronic conditions (heart-attack, stroke, angina, asthma, arthritis, obesity, smoking (current and former), disability, cancer, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, high blood pressure, high cholesterol). among people with depressive disorder compared to people without depressive disorder adjusting for age, gender, race, county, and education were conducted. Prevalence estimates and 95% confidence intervals (CI) were calculated. Weighted analysis procedures were applied using SAS 9.3 software.
RESULTS: An estimated 603,393 (16.9%) of adults in Delaware have ever been told they have a depressive disorder. Higher prevalence was seen among females (65.7%), adults aged 45 through 64 (41.5%), those with lower education (79.7%), white (73.9%), uninsured (80.3%) and living in New Castle County (59.1%). Prevalence of the 14 selected chronic conditions was significantly higher in adult Delawareans with depressive disorder. Adjusted multivariate analyses (multiple models) show odds of depression were significantly higher in adults with each of the selected chronic conditions.
CONCLUSIONS: Epidemiologic studies have provided a strong link between mental illness and the occurrence, course and management of chronic conditions. Given the significant association of depression among Delaware adults with chronic conditions, it follows to reason that state public health programs need to adopt an integrated health approach and incorporate mental health issues into chronic disease interventions. Promotion of mental health would likely result in reducing a considerable proportion of the burden of chronic conditions.