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Multimorbidity is associated with more subsequent depressive symptoms in three months: a prospective study of community-dwelling adults in Hong Kong

Published online by Cambridge University Press:  23 November 2018

Francisco T. T. Lai Open the ORCID record for Francisco T. T. Lai [Opens in a new window] ,
Tsz Wah Ma  and
Wai Kai Hou
Francisco T. T. Lai
Affiliation:
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, 503 Postgraduate Education Centre, Prince of Wales Hospital, Sha Tin, New Territories, Hong Kong
Tsz Wah Ma
Affiliation:
Department of Psychology, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
Wai Kai Hou*
Affiliation:
Department of Psychology, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
*
Correspondence should be addressed to: Wai Kai Hou, Centre for Psychosocial Health, Department of Psychology, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong. Phone: +852-2948-8841. Email: wkhou@eduhk.hk.
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Abstract

Multimorbid adults are more likely to have depression. However, existing data are mostly cross-sectional or retrospective with poor control of baseline depressive symptoms and a focus on long-term effects. This prospective study examined the short-term independent predictive association of multimorbidity with depressive symptoms. We collected baseline and three-month follow-up data from a population-based sample of 300 community-dwellers (aged 18–77) in Hong Kong. Multiple regression was used to examine the predictive association of baseline multimorbidity (two or more physical chronic conditions), relative to having one or zero conditions, with depressive symptoms in three months measured by the Center for Epidemiological Studies-Depression (CES-D, out of 60) scale. Multivariable adjustments were made for socio-demographics, baseline CES-D scores, and baseline self-perceived physical health status. A sub-analysis was conducted to compare multimorbid participants with monomorbid (one condition) ones. In our sample, 48 participants (16%) had multimorbidity. Adjusted analysis showed that on average, multimorbid participants had 2.71 (95% CI, 0.36–5.06, Cohen’s d = 0.128) more points in the CES-D scale at three-month follow-up than non-multimorbid participants (zero or one condition) did, which was independent of baseline CES-D scores, self-perceived physical health status, and socio-demographics. Compared with monomorbid participants, multimorbidity was associated with a similar difference of 2.92 (95% CI, 0.81–5.66, Cohen’s d = 0.220) points. Incremental R-square changes associated with the inclusion of multimorbidity were significant (P < 0.05). In conclusion, the effect of multimorbidity on depressive symptoms may take a shorter period to manifest than previously assumed. The mental health of adults with multimorbidity warrants more attention.

Keywords

epidemiologyolder adultslong-term caremedical comorbidity
Type
Brief Report
Information
International Psychogeriatrics , Volume 31 , Issue 9: Issue Theme: Self-Esteem, Resilience, and Emotional Intelligence , September 2019 , pp. 1367 - 1371
Copyright
© International Psychogeriatric Association 2018 

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