| [Objectives] The aims of the study were to assess the posivite rates of depressive symptoms and anxiety symptoms and the quality of life among people with diabetes mellitus or hypertensions in community, to assess knowledge about mental disorders of this population, to assess the utility of and willingness to community mental health services. The results will be used to guide resourceallocation on mental health education, training and intervention, to prepare for the future development of community mental health services.[Methods](1) Data were obtained from a cross-sectional survey of patients with diabetes mellitus or hypertensions registered in chronic disease electronic archives in Xinhua Jiedao, Huayang Jiedao of Changning District and Xinzhuang Town of Minhang District in Shanghai. 8813 respondents completed the self-report questionnaires including--Patient Health Questionnaire(PHQ-9), Generalized Anxiety Disorders Scale(GAD-7), 12-item short-form(SF-12)TM, Mental Health and Psychological Care Knowledge Questionnaire(QMHK) and Mental Health Service Utilization Questionnaire(self-programmed). The database was managed by Epidata 3.1. And, it was analyzed by SPSS 17.0. The measurement data was descripted as`X±S. The t test of two independent-samples and one-way ANOVA were applied in the intergroup comparion of the mean value, and the intergroup comparion of rate used a chi-square test. The multiple linear regression and unconditional logistic regression were applied in the analysis of factor interactions. The significant level was 0.05.[Results](1) There were 1292 respondents having depressive symptoms(PHQ-9 score≥5), accounting for 14.7% of the total, including 948(10.8%) mild individuals, 219(2.5%) moderate individuals and 125(1.4%) moderate severe individuals. There were 613 respondents having anxiety symptoms(GAD-7 score≥5), accounting for 7.0% of the total, including 473(5.4%) mild individuals, 100(1.1%) moderate individuals and 40(0.5%) severe individuals. The positive rate of either depressive or anxiety symptoms was 16.0%. The positive rate of depressive symptoms among patients with both diabetes and hypertension was the highest, followed by diabetes only, and the positive rate of hypertension only was the lowest(χ2=75.372, P<0.001). And, the positive rate of anxiety symptoms among those with both diabetes and hypertension was higher than hypertension only(χ2=31.160, P<0.001). The results of regression were that those with both diabetes and hypertension and diabetes only had a higher risk of depression or anxiety than those with hypertension only. Less educational level, divorsed/widowed were common risk factors for both depression and anxiety. Age was protective factor for anxiety while female gender and a longer disease duration of diabetes or hypertension were risk factor for depression.(2) The PF score was 49.93(SD9.64) and the PCS was 45.63(SD8.80), slightly lower than the norm of 50. The GH score was 36.24(SD10.15). The PCS and MCS scores of those with diabetes comorbid hypertension and diabetes only were higher than those with hypertension only, and a longer disease duration contributed to a lower score. Female gender, old age, lower educational level, divorsed/widowed and a high score of PHQ-9 were risk factors forlower scores of PCS, while old age, a lower educational level, high scores of PHQ-9 and GAD-7 were to MCS.(3) The proportion of correct reponses of the knowledge questionnaire ranged from 20.3% to 98.4% with mean proportion of 70.0% and mean score of 14.0(SD3.0). Respondents with higher education level or younger ages had a better grasp of knowledge about mental disorders.(4) 77.6% of respondents believed that community mental health services was esential for everyone. 72.3% of respondents said yes to use mental health service when they were suffering from emotional problems, of whom only 2.4%(N=155) had sought mental health professional help. Female, higher education, younger in age and higher mental health knowledge scores predict more positive attitude towards mental health services and more willing to use them. In comparison with respondents without depressive or anxiety symptoms, those with the symptoms had a higher utilization of mental health services(χ2=65.408,P<0.001).[Conclusions] Patients of both diabetes and hypertension were usually co-occurred with depressive symptoms and anxiety symptoms, the quality of life of this population also suffered mildly to morderately. Female gender, old age, divorsed/widowed and a lower educational level were significant risk factors of depressive and anxiety symptoms. People with female, higher education, younger and better knowledge about mental disorders would be more likely seek for mental health services. People with emotional problems were more likely to use mental health service than those without, though the utilization rate was low in both groups. |
