RESUMEN
Objective: To determine the relationship between iron deficiency anemia and depressive disorder; and identify the correlation between severity of anemia and depressive disorder
Study Design: Descriptive, analytical study
Place and Duration of Study: Department of Psychiatry and Medical Reception Center, Sindh Rangers Hospital, Karachi [a secondary healthcare facility], from January to July 2017
Methodology: Depressive disorder was diagnosed by psychiatrist on ICD 10 criteria and severity of symptoms was assessed on HAM-D rating scale. Hundred cases and equal number of age and gender matched controls were enrolled in the study. A semi-structured proforma was used for documenting the socio-demographic factors and outcome variables. Blood samples were taken for Hemoglobin [Hb] level and peripheral film from both groups
Results: Median Hb levels were 11.9 [IQR=1.27]] for depressed patients versus 12.9 [IQR=1.3] for healthy participants. Significant difference between Hb levels of two groups was found [p<0.001], i.e. depressed participants were found to have higher frequency of anemia [73%] as compared to non depressed participants [16%, p=0.001]. Spearman rank correlation coefficient for Hb level and depression was -0.429 [p<0.01], showing significant negative correlation. The odds for Hb level were 0.487 [0.37-0.64], which showed that cases are less likely to be found with higher Hb levels as compared to controls [p<0.001]
Conclusion: This study concludes that there is relationship between iron deficiency anemia and depressive disorder; and severity of symptoms of DD increases with degree of IDA
RESUMEN
Objective: To detect the prevalence of physical co-morbidities according to International Classification of Diseases[ICD-10] among patients with Depressive disorder
Design: Descriptive cross sectional study
Setting: Psychiatric consultation clinic of JPMC Karachi
Methods: Patients of either gender and age >18 years were consecutively selected after informed consent, Ethical issues were addressed according to Institutional Review Board [IRB], JPMC, Karachi. Patients with psychotic symptoms, personality disorders, dementia, and history of substance use were excluded. ICD-10 criteria, beside complete history, physical examination and lab investigations were used to confirm the diagnosis of depression and physical co-morbid. Prescribed questionnaire was used to collect the data and analyzed in SPSS version-17. Descriptive statistics were calculated for age, gender, marital status, education, socioeconomic status and co-morbidity
Results: Total 100 cases fulfilled the inclusion criteria. Their Mean +/-SD age was 32.7 +/-16.7 years. Both genders were equally vulnerable, [50% each]. Fifty three percent had moderate, 31% mild and 16% had severe depressive disorder. Hypertension was the most common [18%] in male patients and sinusitis was the most common [28%] in female patients with depression. Other co-morbidities included Diabetes Mellitus, Epilepsy, Migraine, HCV, Anemia, Chronic Kidney Disease [CKD], Urinary Tract Infection [UTI] and Menopausal syndrome [in women], Obesity, Asthma and Facial pain
Conclusion: Physical co-morbidities are prevalent among patients with depressive disorder. Presence of physical co-morbid may decreases the chances of treatment compliance, increases risk of treatment failure, relapse of depression, worse prognosis and elevated the treatment cost. Early detection and simultaneous management of these co-morbid with depression are suggested