Abstract
OBJECTIVES: This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors. METHODS: This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders. RESULTS: The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend. CONCLUSIONS: Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.