PSYCHOLOGICAL IMPACT OF LIVING WITH DIABETES AND HYPERTENSION IN URBAN SLUMS

Abstract

Background: Chronic illnesses like diabetes mellitus and hypertension are increasingly prevalent in urban slum settings, where poor infrastructure, overcrowding, and limited healthcare services elevate the risk of mental health problems. Residents of these marginalized communities often struggle with poverty, comorbidities, and limited disease management support, which can exacerbate psychological distress. Understanding the mental health burden among this group is crucial to formulating effective, integrated healthcare responses.

Objective: To assess the prevalence of depression and anxiety among individuals with diabetes and hypertension in urban slums of Hyderabad, Pakistan, and to identify associated socio-demographic and clinical factors.

Methods: A cross-sectional descriptive study was conducted among 300 adults diagnosed with diabetes, hypertension, or both for at least six months. Participants were selected using multistage random sampling from selected urban slums. Data were gathered through face-to-face interviews using a structured questionnaire. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Socio-demographic and clinical data were also collected. Data analysis was performed using SPSS version 29, including descriptive statistics and chi-square tests to determine associations between psychological distress and independent variables.

Results: Among 300 participants, 58% were female and 62% had a monthly income of less than 20,000 PKR. Depression symptoms were present in 72%: 34% mild, 25% moderate, and 13% severe. Anxiety symptoms were reported in 76%: 36% mild, 28% moderate, and 12% severe. Psychological distress was significantly more common among women (36%), low-income individuals (46%), those with at least one comorbidity (40%), and those with no or only primary education (38%).

Conclusion: A high prevalence of depression and anxiety was observed among individuals with chronic illnesses in slum communities. Integrating mental health services into chronic disease management is essential, particularly for socially and clinically vulnerable populations.