Multimorbidity and its association with mental health in an adult population of Peru.

Abstract

Background: Motivation for the study. The presence of multimorbidity is increasingly frequent in the general population, and this may be associated with mental health problems. Main findings. The presence of multimorbidity, and a great number of chronic conditions, was associated with a higher prevalence of depressive symptoms, anxiety and perceived stress in an adult population in a region of northern Peru. Implications. Our findings suggest the need for adequate mental health management in patients with more than one chronic disease.

Objective.: To evaluate the association between multimorbidity and mental health in adults aged 30 to 69 years.

Materials and methods.: Secondary data analysis of a population-based study conducted in the peri-urban area of Tumbes in the northern coast of Peru. The dependent variables were: depressive symptoms, using the PHQ-9; anxiety symptoms, using the Goldberg scale; and perceived stress, assessed with the Cohen's 14-question scale. The exposure variable was the presence of multimorbidity (presence or not of two or more chronic conditions and the number of chronic conditions). We assessed associations using crude and adjusted Poisson regression models.

Results.: Data from 1600 participants were analyzed, mean age was 48.1 years (SD: 10.5), and 50.4% were women. The prevalence of multimorbidity was 15.9%, 23.3% presented depressive symptoms, 42.0% anxiety symptoms and 31.4% had high levels of perceived stress. The multivariable model showed that multimorbidity was associated with a higher prevalence of depressive symptoms (61%, 95%CI: 32% - 98%), anxiety symptoms (46%, 95%CI: 28% - 66%) and high (22%, 95%CI: 14% - 33%) but not moderate levels of perceived stress (6%; 95%CI: 0% - 12%). A higher number of chronic conditions was associated with higher prevalence of depressive symptoms, anxiety symptoms, and perceived stress levels.

Conclusions.: The presence of multimorbidity is associated with a higher prevalence of depressive symptoms, anxiety symptoms, and perceived stress levels. Our results suggest the need for adequate mental health management in patients with multimorbidity.