Depression in Chronic Illness Patients Attending OPD Clinics in Rawalpindi: A Mixed-Method Study

Abstract

Mental health disorders, especially depression, are a critical concern among individuals with chronic illnesses, significantly affecting their quality of life and complicating disease management. Depression often goes undiagnosed in outpatient settings, particularly in countries like Pakistan, where healthcare resources are limited. This underdiagnosis exacerbates the burden on healthcare systems and impacts patients' physical health outcomes.

Objectives: The primary aim of this study was to assess the prevalence and impact of depression among chronic illness patients attending outpatient clinics in Rawalpindi, Pakistan, through a mixed-method approach, combining quantitative and qualitative data collection.

Methodology: This mixed-method study employed both quantitative and qualitative techniques. Quantitative data were collected using standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale, from 100 patients. Qualitative data were gathered through in-depth interviews with 15 participants, analyzed using thematic analysis. The statistical analysis of quantitative data involved Spearman’s Rank Correlation, descriptive statistics, and distribution of depression severity.

Results: The study found a high prevalence of moderate to severe depression among chronic illness patients, with a significant positive correlation between depression and anxiety (ρ = 0.741). Thematic analysis of qualitative data revealed that chronic illness exacerbates emotional distress, creating a vicious cycle that worsens both physical and psychological health. Social support from family, peers, and healthcare professionals was identified as a crucial coping mechanism.

Conclusion: The study highlights the high prevalence of depression among chronic illness patients attending OPD clinics and underscores the urgent need for integrated healthcare models that address both physical and mental health. It calls for routine mental health screenings, enhanced healthcare provider training, and personalized interventions to improve patient outcomes.