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Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan
  1. Salima Farooq1,
  2. Tahir Khan2,
  3. Sidra Zaheer2,
  4. Kashif Shafique2,3
  1. 1 Institute of Nursing, Aga Khan University Faculty of Health Sciences, Karachi, Pakistan
  2. 2 School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
  3. 3 Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
  1. Correspondence to Dr Tahir Khan; tahir.khan{at}


Objective This study aimed to estimate the prevalence of anxiety and depressive symptoms and their association with multimorbidity and the demographic characteristics of adults aged 30 years and above in Karachi, Pakistan.

Design Observational cross-sectional study.

Study setting and participants The study was carried out among a general population aged 30 years and above residing in the Gulshan-e-Iqbal town of Karachi, Pakistan. The study participants were recruited using the systematic random sampling approach based on the inclusion criteria. The data collected from 2867 participants were analysed.

Main outcome measures The primary outcome of the study was the prevalence of anxiety and depressive symptoms, measured with the Aga Khan University Anxiety Depression Scale. The secondary outcome was the association of anxiety and depressive symptoms with multimorbidity as well as with the sociodemographic characteristics of the participants, using binary logistic regression.

Results Out of 2867 individuals, 27.4% reported having anxiety and depressive symptoms. The multivariate logistic regression model revealed that the presence of multimorbidity (adjusted OR (AOR)=1.33, 95% CI 1.11 to 1.58), female gender (AOR=2.40, 95% CI 2.01 to 2.87), illiteracy (AOR=1.51, 95% CI 1.09 to 2.07), more children (AOR=0.74, 95% CI 0.59 to 0.93) and visiting a faith healer (AOR=2.29, 95% CI 1.82 to 2.88) were the significant factors associated with anxiety and depressive symptoms.

Conclusion This study revealed a moderately high prevalence of anxiety and depressive symptoms among adults aged 30 years and above in Karachi, Pakistan. The key variables associated with anxiety and depressive symptoms were multimorbidity, female gender, lower level of education, more children and visiting faith healers.

  • multi-morbidity
  • anxiety and depression
  • adult health

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  • Contributors KS and SF conceived the research question and the design of this project. SF conducted all the literature reviews and manuscript drafting and review, and took part in data collection. TK and SZ helped in the data analysis and preparation of tables, and reviewed the manuscript. KS supervised the research project and conducted the final editing and review of the manuscript. The final version of this manuscript was seen and approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study’s proposal was approved by the Institutional Review Board (IRB) of the Dow University of Health Sciences (reference number: IRB-554/DUHS/Approval/2015/04). Only individuals who provided written informed consent were interviewed. A referral plan for counselling was made for participants who scored 20 and above on the AKUADS.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request by the corresponding author.

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