Association Between Medicinal Plant Use and Depression Severity Among Cardiology Patients: A Clinical Pharmacy and Forensic Public Health Study

Abstract

Background: Medicinal plant use is common among patients with cardiovascular disease, but its relationship with depression severity and medication-related characteristics remains insufficiently understood. Objective: To determine the association between medicinal plant use and depression severity among cardiology patients and to describe patterns of medicinal plant use and relevant clinical characteristics. Methodology: A hospital-based cross-sectional study was conducted among 425 adult cardiology patients at Pakistan Institute of Medical Sciences, Islamabad, from March 2024 to February 2025. Data were collected through structured interviews and medical records. Depression severity was assessed using a validated depression assessment instrument, while medicinal plant use, cardiovascular characteristics, comorbidities, and medication burden were documented. Data were analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression. Results: Among 425 patients, 159 (37.41%) reported medicinal plant use and 266 (62.59%) were non-users. Mild depression was present in 121 (28.47%), moderate in 102 (24.00%), moderately severe in 62 (14.59%), and severe depression in 36 (8.47%) patients. Depression severity was significantly associated with medicinal plant use (χ²=12.73, p=0.013). Medicinal plant users had higher odds of greater depression severity (AOR=1.84, 95% CI: 1.23–2.76; p=0.003). Conclusion: Medicinal plant use was significantly associated with greater depression severity, highlighting the importance of documenting herbal medicine use during cardiology care.