Abstract Body: Introduction
Globally approximately 280 million people have depression which accounts for 7.5% YLD and is the single largest contributor to non-fatal health loss. Persons with limited or uncertain access to adequate food (food insecurity-FI) are at increased risk of CVD including hypertension making it a critical public health issue. In some populations it has been suggested that FI might be a stronger predictor of depressive symptoms than some of the traditional CVD risk factors. However, the nature of this association is unclear. The aim was to evaluate the prevalence of depressive symptoms and the association between depressive symptoms and food insecurity among persons with hypertension in Jamaica.
Hypothesis
Depressive symptoms are directly related to food insecurity.
Methods
Cross-sectional study of patients with hypertension attending 2 clinics (1 primary care, 1 specialist hypertension) recruited by sequential sampling. An interviewer administered questionnaire collected socio-demographic (age, sex, marital status, education, employment and comorbidities), depression and food security information. Depressive symptoms were scored using the Patient Health Questionnaire-2 (PHQ-2) based on 2 questions and scored on a scale of 0-6. Questions asked whether, in the last two weeks, participants had a) little pleasure in doing things or b) feeling down or depressed. A score of ≥3 suggested major depressive disorder is likely. A modified 9 item questionnaire based on The Latin America and Caribbean Food Security Scale (ELSCA) classified FI into mild, moderate and severe. Logistic regression was used to assess the association between depressive symptoms and food security.
Results
Data of 247 hypertensive participants 29% male with a mean [SD] age of 65.3 ± 12.2 years were analysed. The prevalence of depressive symptoms was 10.2% (n=26) increased with age (p =0.002) and among those with mild 5.8%, moderate 15.7%, and severe 19.4% of food insecurity, but was not statistically significant. In final model adjusted for age and sex the odds of depressive symptoms were not significantly associated with food insecurity.
Conclusion
One in ten patients with hypertension in these clinics screen positive for depression using the PHQ2 questionnaire. While depressive symptoms were higher among persons with higher levels of food insecurity the association was not statistically significant. These associations should be further explored in larger studies.