Anxiety, depression, and suicidal ideation among patients with non-communicable diseases versus the general population in Southern Tehran: a cross-sectional study

Background Non-communicable diseases are a major cause of illness and death globally, including in Iran. Although associations with mental health have been suggested, evidence from Iran is limited. This study compared 3 mental health outcomes in adults with and without NCDs in southern Tehran. Method This cross-sectional study used secondary data from a telephone-based health survey conducted in southern Tehran (May–September 2023). Adults aged ≥ 25 years were included, yielding a final weighted sample of 1,124 participants. NCD status (hypertension, cardiovascular diseases, dyslipidemia, and diabetes) was self-reported based on prior medical diagnosis. Mental health outcomes (anxiety, depression, suicidal ideation, and overall mental distress) were assessed using validated tools (GAD-2, PHQ-2, GHQ-28 (questions 23 and 25)(. Associations between NCDs and mental health outcomes were examined using multinomial logistic regression and linear regression models, adjusted for sociodemographic and socioeconomic variables. Results Overall, 22% (95% CI = 19.05–24.46) of participants reported at least one NCD. Mental distress scores were significantly higher among individuals with NCDs compared to those without (mean 3.60 (95% CI = 3.06–4.15) vs. 2.60 (95% CI = 2.40–2.80)), p  = 0.001). NCD patients also had higher mean depression (1.49 vs. 1.03, p  = 0.001) and anxiety scores (1.71 vs. 1.32, p  = 0.002). Suicidal ideation was more prevalent among NCD patients (17.61% vs. 11.70%). Multinomial regression showed that participants with NCDs had increased odds of high depression (Adjusted Odds Ratio [AOR] = 2.97, 95% CI = 1.68–5.26), high anxiety (AOR = 2.32, 95% CI = 1.40–3.85), and high overall mental distress (AOR = 2.47, 95% CI = 1.47–4.13) compared to participants without NCDs. Linear regression showed significantly increased scores for overall mental distress (Adjusted β = 0.97, 95% CI = 0.44–1.50), depression (Aβ = 0.44, 95% CI = 0.18–0.70), anxiety (Aβ = 0.36,95% CI = 0.12–0.60), and suicidal ideation (Aβ = 0.19, 95% CI = 0.03–0.36) among NCD patients. Conclusion Adults living with NCDs show markedly higher levels of mental distress than those without these conditions, underscoring the importance of incorporating routine mental health assessment and support into NCD care in Iran.