Burden of depression and anxiety among leprosy affected and associated factors—A cross sectional study from India

Abstract

Background Leprosy is a Neglected Tropical Diseases (NTDs) known to cause stigma and discrimination in low-and middle-income countries. It often results in visible impairments, thus pre-disposing to poor mental health. Aim of the study was to estimate the prevalence of depression and anxiety among people affected by Leprosy and to determine the associated factors. Methodology/Principal findings A multi-centric, cross-sectional study was carried out in four leprosy endemic states of India—Chhattisgarh, Maharashtra, West Bengal and Tamil Nadu in randomly selected blocks (a sub-unit of district), from one district in each state. From selected blocks those registered for leprosy treatment at public health or referral centres, people above the age of 18 years were interviewed with PHQ-9 and GAD-7 questionnaires for Depression and Anxiety, respectively. Disease profile like leprosy classification, deformity grade, number and site of the patches and socio-economic status were collected along with individual data. Of the total 220 respondents, prevalence of depression and anxiety symptoms was, 33% (73) and 19% (42), respectively. Presence of disability (47%) and Female gender (46%) were significantly associated with depression. Presence of disability (32%), Lower income group (27%) and low education (22%) were significantly associated with symptoms of anxiety. As the severity of disability increased, risk of developing depression and anxiety increased. Conclusion The study indicates that more than 30% of people affected by leprosy have mental health problems, which emphasizes the importance of mental health care services in leprosy. Women, those who had lower level of education, those belonging to lower socio-economic status and those with any level of disability due to leprosy are at risk of developing depression and/or anxiety. The study concludes more attention to be paid to the categories identified to be at risk.

Causes and Consequences of Stigma Leading to Mental Disorders Among Leprosy Affected: Key Elements in the Process of Counselling to Improve Mental Health Care

“…(Jindal 2013) 15 . The burden of depression and anxiety is among more than 30% of leprosy affected and at high risk are women, those with lower education, socio-economic status and disabilities (Govindraj 2021) 16 . About (69%) of leprosy affected develop multiple feelings of fear, anxiety and sorrow right at the time of initial diagnosis itself (Govindraj 2018) 17 suggests a need for MH care from the primary stage of leprosy treatment.…”

The Effectiveness of Fear of Leprosy as a Mediator of the Relationship Between Resilience, Coping Resources, and Coping: A Correlation Study Through The Structural Equation Model in Patients with Leprosy

“…For this assumption, that in preventing individuals from developing a fear of leprosy disability, having extensive cooping resources can develop adaptive coping in seeking health assistance. This is because of the disability that lepers always carry throughout their lives, giving them very heavy mental pressure 70 and self stigmatization 61 . Also, the stigma and discrimination that they receive from their environment can add to their suffering 11 .…”

Self-care in leprosy at the front line

“…The usual mental problems are depression and anxiety disorders, which are more prevalent in people affected by leprosy. 20 This is because of disease impairments as well as societal influences, resulting in stigma and discrimination. Symptoms of depression in people affected by leprosy are mostly associated with people isolated from the community; are living alone; have difficulty with self-care and performing daily activities; having visible and visual impairments.…”

“…Symptoms of depression in people affected by leprosy are mostly associated with people isolated from the community; are living alone; have difficulty with self-care and performing daily activities; having visible and visual impairments. 20 This needs a multi-faceted approach at different levels, starting from the individual, family, and community. An intrapersonal focus, using cognitive behavioural approaches focus on improving self-esteem, coping skills and level of felt stigma; building psychological and social confidence; and empowerment of help seeking behaviour, involving families and communities of people affected.…”