Assessment of Psychological Comorbidities Among Noncommunicable Disease Patients in Rural and Urban Areas of a...

Psychiatric comorbidities such as depression, anxiety, and stress are two to threefold higher among patients with noncommunicable diseases (NCDs). These comorbidities are common in individuals with chronic NCDs and are linked to increased mortality and poorer health outcomes. Psychiatric disorders in patients with physical ailments are more likely to be associated with poor lifestyle choices and noncompliance with therapy, greater treatment costs, poor quality of life, deteriorating physical health, absenteeism from work, more hospitalizations, poor self-care, and increased mortality.

This article aims to assess psychological comorbidities among patients with noncommunicable diseases in rural and urban areas of Etawah, a district in northern India.

A community-based cross-sectional study was conducted in both rural and urban areas of Etawah between October 2022 and March 2024. The study included 600 adults aged 18 years and above, of either gender, with one or more noncommunicable diseases. Participants were recruited through a multistage random sampling process. The study subjects were assessed using Patient Health Questionnaires (PHQs) for psychological comorbidities. The university's ethical committee granted approval before the start of the study. IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York), was used for statistical analysis after the data from the selected study units were entered into the SPSS spreadsheet.

Of the 600 study subjects, 306 had at least one psychological comorbidity, accounting for a total prevalence of 51.0%. The prevalence was higher in the urban areas (55.3%) compared with the rural areas (46.7%), with a statistically significant difference (p = 0.034). Stress was the most common psychological comorbidity (50.0%), while anxiety and depression were present in 7.2% and 8.5% of study subjects, respectively.

There was a much higher burden of psychological comorbidities, mainly stress, affecting more than half of the study subjects. In comparison, anxiety and depression were observed more frequently among patients with cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and cancers. The burden of psychological comorbidities was significantly higher in urban areas than in rural ones. Therefore, more research is required to evaluate the factors that predict psychological comorbidities among NCD patients in rural and urban areas to alleviate the burden.