Life sciences · Journal article

Burden of Depressive and Anxiety Symptoms and Associated Factors among Adult Patients Attending a Psychiatry Outpatient Department at a Tertiary Care Centre in Uttarakhand: An Analytical Cross-Sectional Study

Acta Medica International · August 1, 2026

Preliminary Why this matters to you Expert discussion

Early or partial results. Treat as a signal, not a conclusion.

AI Summary

This cross-sectional survey of 700 consecutive psychiatry outpatients in Uttarakhand reports substantial symptom burden: 46.0% with clinically relevant depressive symptoms and 38.0% with anxiety, with 30.0% meeting criteria for both. Sleep difficulty and poor social support emerged as the strongest modifiable and non-modifiable associations, but the design cannot establish causation and findings are geographically limited.

What was studied

Analytical cross-sectional study. Adult patients attending tertiary-care psychiatry outpatient department in Uttarakhand; no specific exclusion criteria stated.. n = 700. One tertiary-care centre in Uttarakhand, India.

Key findings

Clinically relevant depressive symptoms in 46.0% (95% CI, 42.3%-49.7%) Clinically relevant anxiety symptoms in 38.0% (95% CI, 34.5%-41.7%) Both depressive and anxiety symptoms in 30.0% (95% CI, 26.7%-33.5%)

Safety

Self-harm item prevalence reported as count and percentage but context (ideation vs. behaviour, severity) not detailed. 8.0% (56 participants) endorsed self-harm item on PHQ-9

Who this may help

The findings document substantial symptom burden and safety concerns in a regional psychiatry outpatient population and highlight modifiable factors (sleep, social support) amenable to intervention. However, as a single-centre cross-sectional study, results should not guide practice changes without replication in other settings and populations.

Plain-language summary

Single-centre cross-sectional study with descriptive and associational findings in a regional psychiatry setting; no intervention or causal design, and results require confirmation in other populations.

Study design

As stated by the source record.

MethodsConsecutive adult patients attending psychiatry outpatient department from July 2025 to June 2026 were assessed with PHQ-9 and GAD-7; clinically relevant burden defined as score ≥10. Associations examined using chi-square tests and multivariable logistic regression adjusting for sleep difficulty, recent stress, financial strain, social support, and sex.

DesignAnalytical cross-sectional study

PopulationAdult patients attending tertiary-care psychiatry outpatient department in Uttarakhand; no specific exclusion criteria stated.

Sample size700

SettingOne tertiary-care centre in Uttarakhand, India

Reported figures

Quoted from the source exactly as published.

Sample size700

Mean age39.17 years

Female proportion52.0%

Depressive symptom prevalence46.0%

Depressive symptom prevalence 95% CI42.3%-49.7%

Anxiety symptom prevalence38.0%

Anxiety symptom prevalence 95% CI34.5%-41.7%

Comorbid depression and anxiety prevalence30.0%

Clinical bottom line

Caveats

Single-centre study in one Indian state; generalisability to other regions or countries unknown.
Cross-sectional design precludes causal inference; associations observed, not temporal relationships.
Source does not report response rate, refusal reasons, or comparison of participants to non-participants.
Self-harm item prevalence reported as count and percentage but context (ideation vs. behaviour, severity) not detailed.

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

moderate

Cross-sectional design permits prevalence and association estimation but not causation.

Directness

strong

Direct measurement of depressive and anxiety symptoms using validated instruments PHQ-9 and GAD-7.

Consistency

insufficient

Single study; no comparison to other regional or national data provided in source.

Risk of bias

moderate

Consecutive recruitment reduces selection bias; single centre and cross-sectional design limit generalisability.

Sample adequacy

strong

Sample size 700 with reported 95% CIs; adequate for primary prevalence estimates.

Source abstract

Background: Depressive and anxiety symptoms overlap across psychiatric diagnoses and may influence functioning, safety, and service needs. Regional evidence from psychiatry outpatient settings is limited. This study estimated symptom burden and associated factors among adult psychiatry outpatients in Uttarakhand. Material and Methods: This analytical cross-sectional study included 700 consecutive adults attending a tertiary-care psychiatry outpatient department from July 2025 to June 2026. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessed symptoms; scores of 10 or more defined clinically relevant burden. Associations were examined using chi-square tests and multivariable logistic regression. Results: Participants had a mean age of 39.17 years; 52.0% were women. Clinically relevant depressive symptoms were present in 46.0% (95% confidence interval [CI], 42.3%-49.7%), anxiety symptoms in 38.0% (95% CI, 34.5%-41.7%), and both in 30.0% (95% CI, 26.7%-33.5%). Sleep difficulty, recent stress, financial strain, poor social support, and female sex were independently associated with both outcomes. Sleep difficulty had the strongest modifiable association with depression (adjusted odds ratio [aOR], 5.90; 95% CI, 3.80-9.17) and anxiety (aOR, 6.06; 95% CI, 3.90-9.40). Poor social support was associated with depression (aOR, 6.44; 95% CI, 3.65-11.35) and anxiety (aOR, 3.62; 95% CI, 2.10-6.24). Fifty-six participants (8.0%) endorsed the PHQ-9 self-harm item. Conclusion: Depressive and anxiety symptom burden was substantial and frequently comorbid. Routine dimensional screening, safety assessment, and evaluation of sleep and psychosocial adversity may strengthen outpatient care. Keywords: Anxiety; Depression; GAD-7; PHQ-9; Psychiatry outpatient services.

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Veena TejanManeesh BhattMasroof Hasan Khan