Authors (including presenting author) :
TSE TK
Affiliation :
Family Medicine and General Outpatient Department, Kwong Wah Hospital
Introduction :
According to the Hong Kong Mental Morbidity Survey published in 2015, common mental disorders were prevalent among Chinese adults in Hong Kong.
Some guidelines suggest screening of common mental disorders (CMD) in usual care of the general adult population, which is not practical in busy GOPC setting.
Is there any special group of patients that may have higher screen positive rate?
As hypertension is one of the most common chronic illnesses encountered in GOPC, our clinical question is whether those patients who had abnormal ambulatory blood pressure pattern are more likely to have CMD?
For white coat hypertension, it is commonly believed to be related to anxiety, how about nocturnal non-dipping?
Objectives :
1) To estimate the prevalence of PHQ-9 and GAD-7 screened CMD among nocturnal dipping and non-dipping hypertensive patients.
2) To assess the relationship between the nocturnal dipping blood pressure pattern and CMD.
Methodology :
Study Design: Cross-sectional study.
Subjects and Procedure: Subjects were recruited by consecutive sampling. 66 dippers and 66 non-dippers in the general out-patient clinic of Kwong Wah Hospital were invited to complete questionnaires (PHQ-9, GAD-7).
Main Outcome Measures: The prevalence of CMD among nocturnal dipping and non-dipping hypertensive patients. Patient Health Questionnaire 9-item (PHQ-9) was used to screen for depressive symptoms. Generalized Anxiety Disorder Scale 7-item (GAD-7) was used to screen for anxiety symptoms.
Result & Outcome :
Non-dippers had higher scores in both PHQ-9 (4.23 ± 4.41) and GAD-7 (2.70 ± 3.65), compared to dippers’ score of PHQ-9 (2.85 ± 2.95) GAD-7 (2.05 ± 2.86). Only the difference in PHQ-9 was statistically significant (P=0.037). Using the conventional cut-off points, there were more non-dippers in the higher depression or anxiety categories, although that was not statistically significant.
Conclusions:
CMD is highly prevalent among both dipping and non-dipping hypertensive patients. Non-dippers tended to be more likely to have CMD, although it is not statistically significant.
Physicians should be aware of the high prevalance of CMD among hypertensive patients during usual care of patients.
