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

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.