Cardiometabolic multimorbidity and symptoms of common mental disorders in a primary healthcare system for low-income urban population in Pakistan

The objective of the study was to evaluate the prevalence of cardiometabolic multimorbidity and symptoms of common mental disorders, including depression, anxiety, and stress, and association between the two, in primary care clinics for low-income, urban population in Karachi, Pakistan. We performed a descriptive cross-sectional study at two primary healthcare clinics, catering predominantly to low-income families in Karachi. Adults, aged 30 years and above, coming to the two clinics for acute illnesses or for regular follow-up of chronic conditions were recruited. We used convenience sampling to include participants who consented. We excluded pregnant women and individuals presenting with severe acute symptoms. Of the 496 participants, 406 (82%) were women. Cardiometabolic multimorbidity was present in 231 (47%) participants, with diabetes in 297 (60%) and hypertension in 259 (52%) being the most common cardiometabolic conditions. Anxiety, stress, and depression affected 462 (93%), 387 (78%), and 335 (67%) participants, respectively, being higher in women. Only a small percentage of individuals were referred to mental health services (13% at site-1 and 16% at site-2). The study did not find a significant positive association between cardiometabolic multimorbidity and symptoms of common mental disorders. This study highlights the high prevalence of cardiometabolic multimorbidity and symptoms of common mental disorders in a low-income urban population visiting primary care clinics in Pakistan. To better understand the true prevalence of cardiometabolic multimorbidity and its association with mental disorders, future community-based prospective studies with representative population are recommended.