Anxiety and depression in Nepal: prevalence, comorbidity and associations

Abstract

BackgroundAnxiety and depression are two important contributors to the global burden of disease. In many developing countries, including Nepal, their prevalences are yet to be assessed.MethodsA nationwide cross-sectional study was conducted among a representative sample of Nepalese adults aged 18–65 years (N = 2100), selected by multistage random cluster sampling and interviewed at home during unannounced visits. The validated questionnaires included the Hospital Anxiety and Depression Scale (HADS), to detect cases of anxiety (HADS-A), depression (HADS-D) and comorbid anxiety and depression (HADS-cAD), the Eysenck Personality Questionnaire Revised Short Form-Neuroticism (EPQRS-N), and the World Health Organization Quality of Life 8-question scale (WHOQOL-8). Logistic regression analyses were used to explore associations of caseness with four groups of variables: demographic, domicile, substance use, and behavioural and health.ResultsAge- and gender-adjusted point prevalences of HADS-A, HADS-D and HADS-cAD were 16.1, 4.2 and 5.9 % respectively. In a multivariate model, HADS-A was positively associated with urban residence (AOR = 1.82; p < 0.001) and neuroticism (AOR = 1.32; p < 0.001), and negatively with alcohol consumption (AOR = 0.71; p = 0.041). HADS-D was positively associated with marijuana use (AOR = 3.61; p = 0.017) and negatively with quality of life (QoL) (AOR = 0.86; p < 0.001). HADS-cAD was positively associated with widowhood (AOR = 2.71; p = 0.002), urban residence (AOR = 2.37; p = 0.001), living at altitude ≥2000 m (AOR = 2.32; p = 0.002) and neuroticism (AOR = 1.26; p < 0.001), and negatively with alcohol use (AOR = 0.56; p = 0.026) and QoL (AOR = 0.79; p < 0.001).ConclusionDepression and anxiety are important mental health conditions in Nepal, and major contributors to public ill health, being very highly prevalent, comorbid and associated with psychosocial burden. They are also linked to the unique topography, habitation and social structure of the country. High prevalence coupled with the disabling nature of these disorders establishes their health-care priority and their importance in national health policy.

Prevalence of common mental disorders in widowhood: A systematic review and meta-analysis

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The tree-species-specific effect of forest bathing on perceived anxiety alleviation of young-adults in urban forests

“…Urban experience contributes to tension-anxiety of citizens in nearly all ages from 10 to 60 years old (Dekker et al 2008, McKenzie et al 2013, Bruzzese & Klein 2016) through shaping the socioeconomic pressure, physical environment and social interactions (Galea 2011). Results from the Global Burden of Disease Study 2013 revealed that mental and substance disorders collectively accounted for 21.2% all-year life lost to disability (YLD) wherein anxiety was ranked ninth highest specific cause of YLD in both developed and developing countries (Risal et al 2016).…”

Prevalence of geriatric depression in the Kavre district, Nepal: Findings from a cross sectional community survey

“…In the past studies, another cut-off point [4/5] in Thailand [40], and 17.2% in Vietnam [33]. It is noteworthy that depression among adults years) in a recently conducted nationwide study population in Nepal was also found to be higher than the global mean [41].…”

“…Health care practices are largely related to the social norms and values among the community members [11]. In countries like Nepal, there is still a widespread belief that disclosure of mental illness is an embarrassment and may lead to discrimination [41].The stigma associated with mental illness may contribute towards underreporting of mental as opposed to physical symptoms [44]. Using the same cut-off (5/6) of GDS-15, an almost similar prevalence of geriatric depression (47.0%) was reported from India [28], a country with more or less similar sociocultural attributes to Nepal.…”