Relation between Depressive Disorder and Iron Deficiency Anemia among Adults Reporting to a Secondary Healthcare Facility: A Hospital-Based Case Control Study

J Coll Physicians Surg Pak. 2018 Jun;28(6):456-559. doi: 10.29271/jcpsp.2018.06.456.


Objective: To determine the relationship between iron deficiency anemia and depressive disorder; and identify the correlation between severity of anemia and depressive disorder.

Study design: Descriptive, analytical study.

Place and duration of study: Department of Psychiatry and Medical Reception Center, Sindh Rangers Hospital, Karachi (a secondaryhealthcare facility), from January to July 2017.

Methodology: Depressive disorder was diagnosed by psychiatrist on ICD 10 criteria and severity of symptoms was assessed on HAM-D rating scale. Hundred cases and equal number of age and gender matched controls were enrolled in the study. A semi-structured proforma was used for documenting the socio-demographic factors and outcome variables. Blood samples were taken for Hemoglobin (Hb) level and peripheral film from both groups.

Results: Median Hb levels were 11.9 (IQR=1.27)) for depressed patients versus 12.9 (IQR=1.3) for healthy participants. Significant difference between Hb levels of two groups was found (p<0.001), i.e. depressed participants were found to have higher frequency of anemia (73%) as compared to non depressed participants (16%, p=0.001). Spearman rank correlation coefficient for Hb level and depression was -0.429 (p<0.01), showing significant negative correlation. The odds for Hb level were 0.487 (0.37-0.64), which showed that cases are less likely to be found with higher Hb levels as compared to controls (p<0.001).

Conclusion: This study concludes that there is relationship between iron deficiency anemia and depressive disorder; and severity of symptoms of DD increases with degree of IDA.

MeSH terms

  • Adolescent
  • Adult
  • Anemia / blood
  • Anemia / complications
  • Anemia / epidemiology
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / complications*
  • Anemia, Iron-Deficiency / epidemiology
  • Case-Control Studies
  • Depressive Disorder / blood
  • Depressive Disorder / epidemiology
  • Depressive Disorder / etiology*
  • Female
  • Health Facilities
  • Health Surveys
  • Humans
  • Iron / blood
  • Iron / metabolism
  • Iron Deficiencies*
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Young Adult


  • Iron