Introduction: A recent interest has grown in improving the quality of Healthcare through patient satisfaction. The link between patient satisfaction and a broad spectrum of factors have been studied. Yet the association with mental illnesses is scares. 24% of patients attending primary healthcare suffer from unrecognized mental disorder. An anxious patient is less likely to stay focused, while depressed patient hold negative view of life in general.

Aim: To determine the association of anxiety and depressive symptoms in addition to socio-demographic characteristics with patient satisfaction in primary healthcare centers.

Materials and methods: A sample of 304 patients or co-patients aged at least 18 years, attending primary health center were asked to fill out an anonymous questionnaire containing socio-demographic, list of chronic illnesses, a self- reported assessment of anxiety and depression (HAD scale) and patient satisfaction questionnaire (PSQ-18).

Results: 18.4 % evaluated PHC services poorly, this was more characteristic of those of university education (p<0.05).The most positive evaluations were in Interpersonal Manner and Communication skills (mean of 3.63 and 3.41 respectively).The most negative evaluations were in Time Spent with the Doctor and Accessibility and Convenience (mean 2.93 and 3.01 respectively).. The prevalence of anxiety and depression were 42.4 % and 45.4%, respectively. Severe anxiety was significantly associated with living far from the health center (p=0.02). Severe depression was significantly associated with young age, female gender and university education(p<0.05). Regression analysis showed that better satisfaction was observed in less depressed, less anxious, those with lower income, and of secondary education.

Conclusion: Being more anxious, depressed, having higher income and higher education are related to worse satisfaction with primary healthcare services. The satisfaction with the time of consultation, accessibility and convenience of the service were poor.The high prevalence of anxiety and depression among PHC attendants is a major concern.