Date of Defense
7-11-2024 10:00 AM
Location
YANAH Theatre, Second floor, Block C (2C010)
Document Type
Dissertation Defense
Degree Name
Doctor of Philosophy in Public Health
College
College of Medicine and Health Sciences
First Advisor
Prof. Fatima Al Maskari
Keywords
PHQ-8, depression, sleep duration, happiness, self-reported happiness, sociodemographic characteristics.
Abstract
Background: Globally, the prevalence of depression among adults is increasing, adversely affecting public health, daily functioning, and productivity. Epidemiological studies have established a strong correlation between depression and other risk factors. However, the aspects of this relationship have not been thoroughly explored in the United Arab Emirates (UAE). The aim of this study was to explore the association between self-perceived depression and other risk factors, such as sociodemographic characteristics, sleep duration, body mass index (BMI), and underlying chronic diseases such as diabetes and hypertension after adjustment for age and gender, among Emirati Adults. Methods: This cross-sectional study is part of the UAE Healthy Future Study (UAEHFS), one of the first extensive prospective cohort studies in the region focusing on the causes and risk factors for chronic diseases among UAE nationals. For this research, we analyzed the UAEHFS pilot data. We used the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among participants. The prevalence proportion of depression was estimated, and in the complete-case analysis, we applied a multivariate logistic regression model using the binarized PHQ-8 along with other variables. Odds ratios (ORs) with 95% confidence intervals (CI) were computed. A p-value of less than 0.05 was considered statistically significant. All statistical analyses were performed using R software, version 4.2.3. Results: Out of 517 participants who met the inclusion criteria, 487 (94.2 %) completed the questionnaire and were included in the statistical analysis using 100 multiple imputations. After excluding cases with missing values, 231 participants (44.7%) were included in the primary statistical analysis. The median age of participants was 32.0 years (Interquartile Range: 24.0, 39.0). In total, 22 participants (9.5%) reported experiencing depression. When comparing categorical groups within the PHQ-8 depression classification (< 10 versus ≥ 10), a statistically significant difference was observed between the categorical variables. Females have shown significantly higher odds of reporting depression than males, with an odds ratio of 3.2 (95% CI:1.17, 8.88). Unhappy individuals had approximately five times higher odds of reporting depression compared to their happy counterparts. Additionally, for each interquartile-range increase in age and body mass index (BMI), the odds ratios of reporting depression were 0.34 (95% CI: 0.1, 1.0) and 1.8 (95% CI: 0.97, 3.32) respectively. The total PHQ-8 score was statistically significant negatively associated with sleep categories with odds ratios OR of 0.965 (95% CI:0.954, 0.976) and 0.961 (95% CI: 0.948, 0.974) in the univariate and multivariate logistic regression model respectively. The odds ratio for Glycosylated hemoglobin (HbA1c) is 1.033 (95% CI: 0.998, 1.069), indicating a slight increase in the odds of reporting depressive symptoms with higher HbA1c levels. However, the association is not statistically significant as the 95% confidence interval CI includes the value of 1. The odds ratio for blood pressure is 0.99 (95% CI: 0.882, 1.112), indicating no statistically significant association with reporting depressive symptoms as the 95% CI includes the value of 1. Conclusion: Females are more likely to report depression compared to males. Increasing age may reduce the risk of reporting depression. Single individuals exhibit higher levels of depression than their married counterparts. Unhappy individuals have approximately 5-fold higher odds of reporting depression compared to happy individuals. A higher BMI was associated with an increased risk of reporting depression. Additionally, Individuals who reported shorter sleep durations were more likely to report depression than those who reported sleeping 7 hours or more. No significant associations were found between total PHQ-8 scores and blood pressure or HbA1c levels. Significant contributions: The results of this study have significant value for researchers and public health professionals, as they provide novel data on the PHQ-8 score in a healthy UAE population, an area that has not been previously explored. This study enriches our understanding of depression in this context and could inform future public health strategies and research initiatives. It has implications for policymaking, addressing gaps in the health insurance system, and promoting public health efforts, particularly regarding the integration of mental health and public health in the UAE and the Gulf region.
Included in
INVESTIGATING THE BIDIRECTIONAL ASSOCIATION BETWEEN SOCIODEMOGRAPHIC PREDICTORS AND SELF-REPORTED DEPRESSION AMONG ADULTS IN THE UNITED ARAB EMIRATES
YANAH Theatre, Second floor, Block C (2C010)
Background: Globally, the prevalence of depression among adults is increasing, adversely affecting public health, daily functioning, and productivity. Epidemiological studies have established a strong correlation between depression and other risk factors. However, the aspects of this relationship have not been thoroughly explored in the United Arab Emirates (UAE). The aim of this study was to explore the association between self-perceived depression and other risk factors, such as sociodemographic characteristics, sleep duration, body mass index (BMI), and underlying chronic diseases such as diabetes and hypertension after adjustment for age and gender, among Emirati Adults. Methods: This cross-sectional study is part of the UAE Healthy Future Study (UAEHFS), one of the first extensive prospective cohort studies in the region focusing on the causes and risk factors for chronic diseases among UAE nationals. For this research, we analyzed the UAEHFS pilot data. We used the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among participants. The prevalence proportion of depression was estimated, and in the complete-case analysis, we applied a multivariate logistic regression model using the binarized PHQ-8 along with other variables. Odds ratios (ORs) with 95% confidence intervals (CI) were computed. A p-value of less than 0.05 was considered statistically significant. All statistical analyses were performed using R software, version 4.2.3. Results: Out of 517 participants who met the inclusion criteria, 487 (94.2 %) completed the questionnaire and were included in the statistical analysis using 100 multiple imputations. After excluding cases with missing values, 231 participants (44.7%) were included in the primary statistical analysis. The median age of participants was 32.0 years (Interquartile Range: 24.0, 39.0). In total, 22 participants (9.5%) reported experiencing depression. When comparing categorical groups within the PHQ-8 depression classification (< 10 versus ≥ 10), a statistically significant difference was observed between the categorical variables. Females have shown significantly higher odds of reporting depression than males, with an odds ratio of 3.2 (95% CI:1.17, 8.88). Unhappy individuals had approximately five times higher odds of reporting depression compared to their happy counterparts. Additionally, for each interquartile-range increase in age and body mass index (BMI), the odds ratios of reporting depression were 0.34 (95% CI: 0.1, 1.0) and 1.8 (95% CI: 0.97, 3.32) respectively. The total PHQ-8 score was statistically significant negatively associated with sleep categories with odds ratios OR of 0.965 (95% CI:0.954, 0.976) and 0.961 (95% CI: 0.948, 0.974) in the univariate and multivariate logistic regression model respectively. The odds ratio for Glycosylated hemoglobin (HbA1c) is 1.033 (95% CI: 0.998, 1.069), indicating a slight increase in the odds of reporting depressive symptoms with higher HbA1c levels. However, the association is not statistically significant as the 95% confidence interval CI includes the value of 1. The odds ratio for blood pressure is 0.99 (95% CI: 0.882, 1.112), indicating no statistically significant association with reporting depressive symptoms as the 95% CI includes the value of 1. Conclusion: Females are more likely to report depression compared to males. Increasing age may reduce the risk of reporting depression. Single individuals exhibit higher levels of depression than their married counterparts. Unhappy individuals have approximately 5-fold higher odds of reporting depression compared to happy individuals. A higher BMI was associated with an increased risk of reporting depression. Additionally, Individuals who reported shorter sleep durations were more likely to report depression than those who reported sleeping 7 hours or more. No significant associations were found between total PHQ-8 scores and blood pressure or HbA1c levels. Significant contributions: The results of this study have significant value for researchers and public health professionals, as they provide novel data on the PHQ-8 score in a healthy UAE population, an area that has not been previously explored. This study enriches our understanding of depression in this context and could inform future public health strategies and research initiatives. It has implications for policymaking, addressing gaps in the health insurance system, and promoting public health efforts, particularly regarding the integration of mental health and public health in the UAE and the Gulf region.