Associations of Underlying Health Conditions With Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors

Abstract

<b>Objectives:</b> We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB). <b>Methods:</b> A cross-sectional study was conducted on 8,291 outpatients aged 18-85 years, in 18 hospitals and health centers across Vietnam from 14th February to May 31, 2020. We collected the data regarding participant's characteristics, UHC, HB, PB, depression, and anxiety. <b>Results:</b> People with UHC had higher odds of depression (OR = 2.11; <i>p</i> < 0.001) and anxiety (OR = 2.86; <i>p</i> < 0.001) than those without UHC. The odds of depression and anxiety were significantly higher for those with UHC and S-COVID-19-S (<i>p</i> < 0.001); and were significantly lower for those had UHC and interacted with "unchanged/more" physical activity (<i>p</i> < 0.001), or "unchanged/more" drinking (<i>p</i> < 0.001 for only anxiety), or "unchanged/healthier" eating (<i>p</i> < 0.001), and high PB score (<i>p</i> < 0.001), as compared to those without UHC and without S-COVID-19-S, "never/stopped/less" physical activity, drinking, "less healthy" eating, and low PB score, respectively. <b>Conclusion:</b> S-COVID-19-S worsen psychological health in patients with UHC. Physical activity, drinking, healthier eating, and high PB score were protective factors.