Psychological Distress Screening for Depression, Anxiety and Stress among Medical Ward Patients in Hospital Tapah, Malaysia: A Cross-Sectional Study Using The Depression, Anxiety and Stress Scale (DASS-21)
Abstract
Objectives: The mental health (MH) issue has emerged as one of the great public health concerns worldwide, and its prevalence is escalating substantially among Malaysians. An individual’s daily living, physical health, and relationships can be hard-hit by an MH disorder. The present study aimed to (i) estimate the probable psychological distress in warded adult patients at Hospital Tapah, Malaysia, and (ii) investigate the key antecedents intrinsically linked to depression, anxiety, and stress that may precipitate psychological distress symptoms.
Material and Methods: This study was a cross-sectional questionnaire-based study involving 191 participants sampled from the warded adult patients at Hospital Tapah. The psychological distress was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Data were analysed by logistic regression using SPSS 16.0.
Results: Anxiety (34.0%) was detected as the highest prevalence of probable psychological distress by a wide margin, trailed by stress (16.8%) and depression (15.2%). Race, Orang Asli (native people) and mental health awareness were associated with the depression. Respondents who exercised regularly, were employed, non-smokers, non-alcoholic drinkers, and without mental health awareness were at risk of anxiety. Income was found to be significantly associated with stress.
Conclusion: This study detected a two-fold increase in the risk of anxiety compared to stress and depression. Further studies should be conducted to identify the factors related to the high DASS-21 scores in detail.
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World Health Organization. Investing in mental health. Geneva: WHO; 2003.
Ministry of Health Malaysia. National health & morbidity survey 2015. Malaysia: Institute for Public Health; 2015.
World Health Organization. Mental health atlas 2011. Geneva: WHO; 2011.
Tsuey Chong S, Mohamad MS, Er AC. The mental health development in Malaysia: History, current issue and future development. Asian Social Science 2013;9:1–8.
Biologically-inspired biomarkers for mental disorders. EBioMedicine 2017;17:1-2.
Guan NC. A review of depression research in Malaysia. Medical Journal of Malaysia 2014;69(Suppl A):42–5.
Tee CA, Salido EO, Reyes PWC, Ho RC, Tee ML. Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus. Open Access Rheumatol Res Rev 2020;12:215.
Le TA, Le MQT, Dang AD, Dang AK, Nguyen CT, Pham HQ, et al. Multi-level predictors of psychological problems among methadone maintenance treatment patients in different types of settings in Vietnam. Subst Abus Treat Prev Policy 2019;14:1–10.
Rehman A Ur, Kazmi SF. Prevalence and level of depression, anxiety and stress among patients with type-2 diabetes. Annals of PIMS-Pakistan Institute Med Sci 2015;11:81-6.
Hosmer DW, Lemeshow S, Sturdivant RX. Applied logistic regression. 3rd ed. Hoboken: John Wiley & Sons; 2013.
World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: WHO; 2017.
Wang C, Tee M, Roy AE, Fardin MA, Srichokchatchawan W, Habib HA, et al. The impact of COVID-19 pandemic on physical and mental health of Asians: a study of seven middleincome countries in Asia. PLoS One 2021;16:e0246824.
Wang C, Tripp C, Sears SF, Xu L, Tan Y, Zhou D, et al. The impact of the COVID-19 pandemic on physical and mental health in the two largest economies in the world: a comparison between the United States and China. J Behav Med 2021;1:1.
Wang C, López-Núñez MI, Pan R, Wan X, Tan Y, Xu L, et al. The impact of the COVID-19 pandemic on physical and mental health in China and Spain: cross-sectional study. JMIR Form Res 2021;5:e27818.
Wang C, Fardin MA, Shirazi M, Pan R, Wan X, Tan Y, et al. Mental health of the general population during the 2019 coronavirus disease (COVID-19) pandemic: a tale of two developing countries. Psychiatry Int 2021;2:71-84.
Taylor DJ, Lichstein KL, Durrence HH, Reidel BW, Bush AJ. Epidemiology of insomnia, depression, and anxiety. Sleep 2005;28:1457–64.
Kaur G, Tee GH, Ariaratnam S, Krishnapillai AS, China K. Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting. BMC Fam Pract 2013;14:69.
Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Reports 2018;8:1-10.
World Health Organization. Mental health atlas 2017. Geneva: WHO; 2017.
Livingston JD, Tugwell A, Korf-Uzan K, Cianfrone M, Coniglio C. Evaluation of a campaign to improve awareness and attitudes of young people towards mental health issues. Soc Psychiatry Psychiatr Epidemiol 2013;48:965–73.
Dumesnil H, Verger P. Public awareness campaigns about depression and suicide: a review. Psychiatric Services 2009; 60:1203-13.
Chekroud SR, Gueorguieva R, Zheutlin AB, Paulus M, Krumholz HM, Krystal JH, et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry 2018;5:739–46.
Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2010;2:72.
Anxiety and Depression Association of America. Exercise for stress and anxiety [monograph on the Internet]. United States: Anxiety and Depression Association of America; 2021 [cited 2021 May 10]. Available from: https://adaa.org/living-withanxiety/managing-anxiety/exercise-stress-and-anxiety
Ho Su Hui C, Ho CS, Chee CY. Mental health strategies to combat the psychological impact of coronavirus disease 2019 (COVID-19) beyond paranoia and panic. Ann Acad Med Singap 2020;49:155-60.
Zhang MWB, Ho RCM. Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technol Heal Care 2017;25:163–5.
Hassan R, Zulkifli MM, Ahmad I, Yusoff SSM. Depression, anxiety and stress among obese patients with chronic illnesses: Prevalence and associated factors in North East Malaysia. Bangladesh J Med Sci 2019;18:252–9.
Morissette SB, Tull MT, Gulliver SB, Kamholz BW, Zimering RT. Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychological Bulletin 2007;133: 245-72.
Rashid RA, Kanagasundram S, Danaee M, Majid HA, Sulaiman AH, Zahari MMA, et al. The prevalence of smoking, determinants and chance of psychological problems among smokers in an urban community housing project in Malaysia. Int J Environ Res Public Health 2019;16:1762.
Mental Health Foundation. Smoking and mental health [monograph on the Internet]. United Kingdom: Mental Health Foundation; 2016 [cited 2020 Dec 6]. Available from: https://www. mentalhealth.org.uk/a-to-z/s/smoking-and-mental-health
Tembo C, Burns S, Kalembo F. The association between levels of alcohol consumption and mental health problems and academic performance among young university students. PLoS One 2017. doi.org/10.1371/journal.pone.0178142.
Villarosa MC, Moorer KD, Madson MB, Zeigler-Hill V, Noble JJ. Social anxiety and alcohol-related negative consequences among college drinkers: do protective behavioral strategies mediate the association? Psychol Addict Behav 2014;28: 887–92.
Kushner MG, Abrams K, Borchardt C. The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clin Psychol Rev 2000;20: 149–71.
Watkins M. The Connection between Anxiety and Alcohol [monograph on the Internet]. United States: American Addiction Centers; 2021 [cited 2021 May 10]. Available from: https:// americanaddictioncenters.org/alcoholism-treatment/anxiety
Yeshaw Y, Mossie A. Depression, anxiety, stress, and their associated factors among Jimma University staff, Jimma, Southwest Ethiopia, 2016: a cross-sectional study. Neuropsychiatr Dis Treat 2017;13:2803–12.
Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med 2017;53:77–84.
Sareen J, Afifi TO, McMillan KA, Asmundson GJG. Relationship between household income and mental disorders: findings from a population-based longitudinal study. Arch Gen Psychiatry 2011;68:419–27.
McMullen M, Lau PKH, Taylor S, McTigue J, Cook A, Bamblett M, et al. Factors associated with psychological distress amongst outpatient chemotherapy patients: an analysis of depression, anxiety and stress using the DASS-21. Appl Nurs Res 2018;40: 45–50.
Husain SF, Yu R, Tang TB, Tam WW, Tran B, Quek TT, et al. Validating a functional near-infrared spectroscopy diagnostic paradigm for Major Depressive Disorder. Sci Reports 2020;10:1–9.
Ho CSH, Lim LJH, Lim AQ, Chan NHC, Tan RS, Lee SH, et al. Diagnostic and predictive applications of functional near-infrared spectroscopy for major depressive disorder: a systematic review. Front Psychiatry 2020;11:378.
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