Anxiety and depression: ten-year changes of prevalence and its association with demographic and socio-economic characteristics according to the ESSE-RF study

Abstract

Aim. To analyze the prevalence of anxiety and depression in Russians using the Hospital Anxiety and Depression Scale (HADS) during the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. To study the associations of increased levels of anxiety and depression (HADS-A/ HADS-D ≥8+) with demographic and socio-economic characteristics according to the ESSE-RF3 study.Material and methods. In the ESSE-RF3 study, a representative sample of the population of 15 Russian regions aged 35-74 years was examined with a response >70%. After removing respondents with missing data from the analysis, the final sample was 28716 people. The level of anxiety/depression was assessed by the sum of points <8 — "normal", ≥8 <11 — subclinical, ≥8+ — increased, ≥11 — clinical (high level). The changes in HADS-A/HADS-D over time were studied in a single age range of 35-64 years with the inclusion of materials from the ESSE-RF (2012-2014) and ESSE-RF2 (2017) studies. Statistical analysis was performed using the open-source R environment (version 4.1). Analysis of the association between factors and a binary variable was carried out using the logistic regression method. The significance level for all tested hypotheses was p≲0,05.Results. In the Russian cohort (ESSE-RF3), the average level of anxiety/depression was 4,3±3,7/3,9±3,4, respectively, while the prevalence of subclinical/clinical anxiety and depression was 19,3/6,8% and 15,9/4,5%, respectively. The prevalence rates of HADS-A/HADS-D ≥8 <11 and HADS-A ≥11 in the ESSE-RF and ESSE-RF2 studies were significantly higher (p<0,001) compared with data from the ESSE-RF3 study. Regression analysis of HADS-D ≥8+ in men and women in models (M1 and M2) showed a significant (p<0,001) association with age 55-74 years, with secondary and less than secondary education and income, as well with diseases (men ≥2 and women ≥1) and women living in rural areas (p=0,019).Conclusion. Data analysis showed significant (p<0,001) lower values of the standardized prevalence of anxiety and depression in men and women in ESSE-RF3 compared with the ESSE-RF and ESSE-RF2 studies. The exception were women with HADS-D ≥11, among which its prevalence in ESSE-RF3 did not differ significantly from that in ESSERF2. Regression analysis showed different associations of anxiety and depression with socioeconomic and demographic indicators in men and women.

Keywords

• prevalence
• anxiety
• depression
• hads
• esse-rf