title: Comorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria.
abstract: OBJECTIVE
  To assess the comorbidity and correlates of depression in chronic diseases in the community in Aleppo, Syria. This has never been previously investigated in an Arab country.
  
  
  METHODS
  We conducted a cross-sectional, population-based study in Aleppo on adults aged 18-65 (N = 2038). We collected data utilizing a structured interview questionnaire. Socio-demographics, general health information, and self-report of physician-diagnosed depression and chronic diseases active in the past year were obtained. We used logistic regression to estimate the odds of depression in chronic diseases and socio-demographic correlates of depression comorbid with chronic diseases.
  
  
  RESULTS
  Mean age (SD) was 35.3 (12.1) years, 55% were female. In women, predictors of depression were heart disease (OR = 3.95, 95% CI: 1.50-10.40), hypertension (OR = 2.92, 95% CI: 1.53-5.55), and kidney disease (OR = 2.96, 95% CI: 1.64-5.32). Depression comorbidity with any chronic disease decreased in higher socio-economic status (middle vs. low: OR = 0.28, 95% CI: 0.12-0.65; high vs. low: OR = 0.20, 95% CI: 0.05-0.81). In men, predictors of depression were rheumatism (OR = 7.10, 95% CI: 2.58-19.60) and respiratory disease (OR = 3.77, 95% CI: 1.23-11.60). Depression comorbidity decreased in residence in formal zones (OR = 0.22, 95% CI: 0.06-0.80).
  
  
  CONCLUSIONS
  Depression is associated with many chronic diseases in the community in Aleppo, a finding consistent with reports from other cultures. Potential gender-related risk factors were identified. Findings inform public mental health planning and support the delivery of depression treatment in primary care settings.
authors: American Lake Division, VA Puget Sound Health Care System, Tacoma, Washington 98493, USA. nael.kilzieh@va.gov
authors: Nael
authors: N
authors: Kilzieh
authors: Samar
authors: S
authors: Rastam
authors: Wasim
authors: W
authors: Maziak
authors: Kenneth D
authors: KD
authors: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D013593:Syria; D055815:Young Adult