Prevalence and determinants of depression, anxiety, and perceived stress among patients with chronic comorbidity attending outpatient clinics in Addis Ababa during the COVID-19 pandemic

The COVID-19 pandemic has disproportionately affected individuals with chronic conditions, increasing risks of severe illness and psychological distress. In Ethiopia, limited healthcare access and disrupted social support have heightened depression, anxiety, and stress, yet evidence on this population remains scarce. This study assessed the prevalence and determinants of depression, anxiety, and perceived stress among patients with chronic comorbidity in Addis Ababa during the COVID-19 pandemic. A cross-sectional study was conducted from April to June 2021 at St. Paul's Hospital Millennium Medical College and Black Lion Hospital. A total of 437 adults were selected using systematic random sampling, and 426 participants were included in the analysis. Data were collected using Hospital Anxiety and Depression Scale (HADS), the 10-item Perceived Stress Scale (PSS-10-C), and Oslo-3 Social Support Scale. Logistic regression analysis was used to identify factors associated with psychological distress. The mean age of participants was 49.6 years; 52.1% were female. Hypertension, heart disease, and diabetes were the most common chronic conditions, and 46.5% of participants had multiple comorbidities. Severe perceived stress was reported by 45.5% of participants, while depression and anxiety were identified in 39.7% and 26.5% of participants, respectively, based on combined proportion of participants with borderline and abnormal levels on the HADS. Higher psychological distress was associated with younger age, multiple comorbidities, female sex, unmarried status, low education, and poor social support. The findings indicate that the COVID-19 pandemic has amplified mental health challenges among patients with chronic illnesses in Addis Ababa. Integrating targeted psycho-social interventions and conducting longitudinal studies are essential to mitigate long-term mental health impacts of the pandemic.