The impact of leprosy on the mental wellbeing of leprosy-affected persons and their family members – a systematic review

Abstract

Leprosy has long-term consequences related to impairment and stigma. This includes a major impact on mental health. This study aims to consolidate current evidence regarding the mental health impact of leprosy on affected persons and their family members. In addition, determinants influencing mental health outcomes among leprosy-affected persons and effective interventions are examined. A keyword-based search was conducted in PubMed, Web of Science, Scopus, PsycINFO, Infolep and InfoNTD; additional literature was also considered. Articles presenting primary data involving leprosy-affected persons or their family members experiencing mental conditions were included. Independent extraction of articles was executed using predefined data fields. Articles were sorted according to relevance. In total, 65 studies were included in this systematic review. Multiple psychiatric morbidities have been identified among leprosy-affected persons, including depression, anxiety disorders and suicide (attempts). Additional factors were found that may impact mental health. Moreover, studies found that demographic factors, lifestyle and disease-specific factors and stigma and discrimination impact mental health. Depressive symptoms and low self-esteem were identified among children of leprosy-affected persons. In addition, interventions were identified that could improve the mental wellbeing of leprosy patients. Depressive disorders and anxiety disorders were found to be very common among persons affected by leprosy. Feelings such as fear, shame and low self-esteem are also experienced by those affected, and their children. Further research is necessary to ensure that mental health impact is included when determining the burden of disease for leprosy, and to relieve this burden.

Revised estimates of leprosy disability weights for assessing the global burden of disease: A systematic review and individual patient data meta-analysis

“…The derived weights were not corrected for comorbidity, because no data was recorded for comorbidity in most studies. Though, the SF-36 has been designed to provide only a general measure of mental health for most conditions, the use of more sensitive instruments for measuring patient experiences like anxiety and depression [39] would have contributed to more accurate estimates of disability burden in leprosy. Quality appraisal of the included studies was not conducted, because the main focus of the research question was on estimating new weights from the individual participant data that were observed at baseline.…”

Knowledge, attitude, and health seeking behavior on leprosy among urban adults in Kancheepuram district of Tamil Nadu

“…[ 13 18 19 ] Owing to these stigmas, leprosy patients tend to suffer from psychosocial problems such as depression and anxiety. [ 20 ]…”

Strengthening individual and family resilience against leprosy-related discrimination: A pilot intervention study

“…Social stigma may impact the emotions, thoughts, behaviour and relationships of persons who are stigmatised [ 4 ]. Not surprisingly, leprosy has been associated with anxiety disorders, depression, suicide (attempts), mental distress and emotions such as fear and shame, low self-esteem and reduced quality of life [ 5 ]. Close contacts of persons affected, such as family members and friends, may also be negatively impacted by such social and psychological consequences of the disease [ 5 ].…”

“…Though leprosy can have a major impact on psychosocial wellbeing [ 5 ], there is also evidence that persons affected by leprosy can overcome experiences of discrimination and exclusion [ 6 ]. Studies indicate that people who have faced severe stigmatisation and have gone on to overcome this adversity demonstrate numerous dimensions of resilience [ 7 , 8 ].…”