{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:57:34Z","timestamp":1790132254685,"version":"4.0.1"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Asian Journal of Psychiatry"],"published-print":{"date-parts":[[2022,1]]},"DOI":"10.1016\/j.ajp.2021.102959","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T11:46:54Z","timestamp":1638272814000},"page":"102959","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"special_numbering":"C","title":["Depression and generalised anxiety and associated factors among adults in Bhutan: Results of national cross-sectional survey in 2019"],"prefix":"10.1016","volume":"67","author":[{"given":"Supa","family":"Pengpid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Peltzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajp.2021.102959_bib1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.healthplace.2016.08.013","article-title":"Income inequality and depressive symptoms in South Africa: a longitudinal analysis of the National Income Dynamics Study","volume":"42","author":"Adjaye-Gbewonyo","year":"2016","journal-title":"Health Place"},{"key":"10.1016\/j.ajp.2021.102959_bib2","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s10389-006-0024-x","article-title":"Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ)","volume":"14","author":"Armstrong","year":"2006","journal-title":"J. Public Health"},{"key":"10.1016\/j.ajp.2021.102959_bib3","unstructured":"Australian Government , 2018. Alcohol screen (AUDIT). \u3008http:\/\/nceta.flinders.edu.au\/files\/3314\/ 2257\/4957\/Right_Mix_3.pdf\u3009. (Accessed 10 October 2020)."},{"issue":"4","key":"10.1016\/j.ajp.2021.102959_bib4","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1620\/tjem.242.317","article-title":"Secondhand smoking is associated with poor mental health in Korean adolescents","volume":"242","author":"Bang","year":"2017","journal-title":"Tohoku J. Exp. Med."},{"issue":"5","key":"10.1016\/j.ajp.2021.102959_bib5","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1017\/S003329171200147X","article-title":"Global prevalence of anxiety disorders: a systematic review and meta-regression","volume":"43","author":"Baxter","year":"2013","journal-title":"Psychol. Med."},{"issue":"5","key":"10.1016\/j.ajp.2021.102959_bib6","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1017\/S0033291716002889","article-title":"Patterns and correlates of major depression in Chinese adults: a cross-sectional study of 0.5 million men and women","volume":"47","author":"Chen","year":"2017","journal-title":"Psychol. Med."},{"key":"10.1016\/j.ajp.2021.102959_bib7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jad.2017.05.031","article-title":"Determinants and geographical variation in the distribution of depression in the Southern cone of Latin America: a population-based survey in four cities in Argentina, Chile and Uruguay","volume":"220","author":"Daray","year":"2017","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.ajp.2021.102959_bib8","unstructured":"Department of Public Health, Ministry of Health, 2020. Non-communicable Disease Risk Factors: Bhutan STEPS Survey 2019, Thimphu. \u3008https:\/\/extranet.who.int\/ncdsmicrodata\/index.php\/catalog\/855\/related-materials\u3009. (Accessed 5 August 2021)."},{"issue":"11","key":"10.1016\/j.ajp.2021.102959_bib9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001547","article-title":"Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010","volume":"10","author":"Ferrari","year":"2013","journal-title":"PLoS Med."},{"issue":"11","key":"10.1016\/j.ajp.2021.102959_bib10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001547","article-title":"Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010","volume":"10","author":"Ferrari","year":"2013","journal-title":"PLoS Med."},{"issue":"14","key":"10.1016\/j.ajp.2021.102959_bib11","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1080\/10826084.2017.1312447","article-title":"Neural correlates of depressive symptoms in smokers - a systematic review of imaging studies","volume":"52","author":"Gonzalez","year":"2017","journal-title":"Subst. Use Misuse"},{"key":"10.1016\/j.ajp.2021.102959_bib12","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/1471-244X-14-128","article-title":"The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review","volume":"14","author":"Haller","year":"2014","journal-title":"BMC Psychiatry"},{"key":"10.1016\/j.ajp.2021.102959_bib13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jad.2020.07.020","article-title":"Depression, anxiety and health status across different BMI classes: a representative study in Germany","volume":"276","author":"Herhaus","year":"2020","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.ajp.2021.102959_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajp.2020.102041","article-title":"Prevalence of mental disorders in South Asia: an umbrella review of systematic reviews and meta-analyses","volume":"51","author":"Hossain","year":"2020","journal-title":"Asian J. Psychiatry"},{"key":"10.1016\/j.ajp.2021.102959_bib15","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s12888-015-0648-x","article-title":"Prevalence, associated factors and predictors of anxiety: a community survey in Selangor, Malaysia","volume":"15","author":"Kader Maideen","year":"2015","journal-title":"BMC Psychiatry"},{"issue":"4","key":"10.1016\/j.ajp.2021.102959_bib16","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1002\/da.20634","article-title":"Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative","volume":"27","author":"Kessler","year":"2010","journal-title":"Depress Anxiety"},{"issue":"1","key":"10.1016\/j.ajp.2021.102959_bib17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1186\/s12888-021-03273-4","article-title":"A national survey on depressive and anxiety disorders in Afghanistan: a highly traumatized population","volume":"21","author":"Kovess-Masfety","year":"2021","journal-title":"BMC Psychiatry"},{"issue":"9","key":"10.1016\/j.ajp.2021.102959_bib18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"issue":"1","key":"10.1016\/j.ajp.2021.102959_bib19","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/1359105311409788","article-title":"Depression and chronic illness: a test of competing hypotheses","volume":"17","author":"Liew","year":"2012","journal-title":"J. Health Psychol."},{"issue":"1","key":"10.1016\/j.ajp.2021.102959_bib20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1093\/fampra\/cmp071","article-title":"Prevalence, incidence, morbidity and treatment patterns in a cohort of patients diagnosed with anxiety in UK primary care","volume":"27","author":"Mart\u00edn-Merino","year":"2010","journal-title":"Fam. Pract."},{"key":"10.1016\/j.ajp.2021.102959_bib21","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1136\/bmj.328.7443.794","article-title":"Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: Systematic review","volume":"328","author":"Mirza","year":"2004","journal-title":"Br. Med. J."},{"issue":"3","key":"10.1016\/j.ajp.2021.102959_bib22","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1017\/S0033291706009640","article-title":"Generalized anxiety disorder and depression: childhood risk factors in a birth cohort followed to age 32","volume":"37","author":"Moffitt","year":"2007","journal-title":"Psychol. Med."},{"key":"10.1016\/j.ajp.2021.102959_bib23","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2753\/IMH0020-7411420403","article-title":"Review of studies of mental health in Bangladesh, with a focus on depression","volume":"42","author":"Newman","year":"2013","journal-title":"Int. J. Ment. Health"},{"issue":"1","key":"10.1016\/j.ajp.2021.102959_bib24","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3346\/jkms.2013.28.1.128","article-title":"Prevalence and correlates of depressive symptoms in korean adults: results of a 2009 Korean community health survey","volume":"28","author":"Oh","year":"2013","journal-title":"J. Korean Med. Sci."},{"key":"10.1016\/j.ajp.2021.102959_bib25","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ajp.2018.03.017","article-title":"High prevalence of depressive symptoms in a national sample of adults in Indonesia: Childhood adversity, sociodemographic factors and health risk behaviour","volume":"33","author":"Peltzer","year":"2018","journal-title":"Asian J. Psychiatry"},{"issue":"7","key":"10.1016\/j.ajp.2021.102959_bib26","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.3390\/ijerph16071251","article-title":"High sedentary behaviour and low physical activity are associated with anxiety and depression in Myanmar and Vietnam","volume":"16","author":"Pengpid","year":"2019","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"6","key":"10.1016\/j.ajp.2021.102959_bib27","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1192\/bjp.bp.110.083915","article-title":"Prevalence of anxiety and its correlates among older adults in Latin America, India and China: cross-cultural study","volume":"199","author":"Prina","year":"2011","journal-title":"Br. J. Psychiatry J. Ment. Sci."},{"key":"10.1016\/j.ajp.2021.102959_bib28","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12888-016-0810-0","article-title":"Anxiety and depression in Nepal: prevalence, comorbidity and associations","volume":"16","author":"Risal","year":"2016","journal-title":"BMC Psychiatry"},{"issue":"8","key":"10.1016\/j.ajp.2021.102959_bib29","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/bul0000102","article-title":"Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms","volume":"143","author":"Salk","year":"2017","journal-title":"Psychol. Bull."},{"issue":"11","key":"10.1016\/j.ajp.2021.102959_bib30","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.3346\/jkms.2017.32.11.1861","article-title":"Prevalence and associated factors of depression in general population of Korea: results from the Korea National Health and Nutrition Examination Survey, 2014","volume":"32","author":"Shin","year":"2017","journal-title":"J. Korean Med. Sci."},{"issue":"2","key":"10.1016\/j.ajp.2021.102959_bib31","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-018202","article-title":"Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan\u2019s Gross National Happiness Study, 2015","volume":"8","author":"Sithey","year":"2018","journal-title":"BMJ Open"},{"issue":"10","key":"10.1016\/j.ajp.2021.102959_bib32","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"issue":"12","key":"10.1016\/j.ajp.2021.102959_bib33","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1176\/ps.2008.59.12.1383","article-title":"Depression and anxiety in the United States: findings from the 2006 behavioral risk factor surveillance system","volume":"59","author":"Strine","year":"2008","journal-title":"Psychiatr. Serv."},{"issue":"6","key":"10.1016\/j.ajp.2021.102959_bib34","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/archinternmed.2011.2174","article-title":"Sitting time and all-cause mortality risk in 222 497 Australian adults","volume":"172","author":"van der Ploeg","year":"2012","journal-title":"Arch. Intern. Med."},{"issue":"1","key":"10.1016\/j.ajp.2021.102959_bib35","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ajp.2011.01.005","article-title":"Mental health in Vietnam: Burden of disease and availability of services","volume":"4","author":"Vuong","year":"2011","journal-title":"Asian J. Psychiatry"},{"issue":"4","key":"10.1016\/j.ajp.2021.102959_bib36","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1017\/S1368980008002802","article-title":"Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians","volume":"12","author":"Wen","year":"2009","journal-title":"Public Health Nutr."},{"key":"10.1016\/j.ajp.2021.102959_bib37","unstructured":"World Health Organization (WHO), 2018a. Bhutan: Noncommunicable Diseases (NCD) Country Profiles, 2018. \u3008chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/viewer.html?pdfurl=https%3A%2F%2Fwww.who.int%2Fnmh%2Fcountries%2Fbtn_en.pdf%3Fua%3D1&clen=79512&chunk=true\u3009. (Accessed 2 August 2021."},{"key":"10.1016\/j.ajp.2021.102959_bib38","unstructured":"World HealthOrganization (WHO), 2018b. STEPwise Approach to Surveillance (STEPS). \u3008https:\/\/www.who.int\/ncds\/surveillance\/steps\/en\/\u3009. (Accessed 22 August 2021)."}],"container-title":["Asian Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876201821004159?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876201821004159?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T16:43:03Z","timestamp":1761756183000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1876201821004159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":38,"alternative-id":["S1876201821004159"],"URL":"https:\/\/doi.org\/10.1016\/j.ajp.2021.102959","relation":{},"ISSN":["1876-2018"],"issn-type":[{"value":"1876-2018","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Depression and generalised anxiety and associated factors among adults in Bhutan: Results of national cross-sectional survey in 2019","name":"articletitle","label":"Article Title"},{"value":"Asian Journal of Psychiatry","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajp.2021.102959","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"102959"}}