Depression and mental wellbeing in people affected by leprosy in southern Nepal

Figures & data

Table 1. Characteristics of people affected by leprosy and the reference group in South-East Nepal.

	Leprosy- affected n (%) N = 142	Reference n (%) N = 54
Mean age (SD)	56.8 (13.54)	61.1 (15.193)
Gender, male	73 (51.4)	20 (37.0)
Living in rural area	127 (89.4)	50 (92.6)
District**
Dhanusha	58 (40.8)	33 (61.1)
Mahottari	63 (44.4)	10 (18.5)
Sarlahi	21 (14.8)	11 (20.4)
Religion, Hinduism	135 (95.1)	53 (98.1)
Caste, low	109 (76.8)	45 (83.3)
Education, illiterate	119 (83.8)	49 (90.7)
Marital status, married	110 (77.5)	41 (75.9)
Occupation
Own business	15 (10.6)	6 (11.1)
Employed	10 (7.0)	0
Unemployed	6 (4.2)	0
Agricultural labor	57 (40.1)	17 (31.5)
Household work	54 (38.0)	31 (57.4)
Disability grade, grade 2	23 (16.2)	NA
How many months ago diagnosed (SD)	170.3 (137.4)	NA

For categorical variables Pearson’s Chi-square test was performed and for continuous normally distributed variables (age) a student’s t-test was performed. A p-value ≤ 0.05 was considered significant. *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001. SD = Standard deviation. N = total number of subjects in that group. n = number of subjects within that category.

Figure 1. Prevalence of depression (total PHQ-9 score ≥ 10), poor mental wellbeing (total WEMWBS score ≤ 45) and thoughts about self-harm or suicide (score PHQ-9 question 9 ≥ 1) in the leprosy affected (n = 142) and reference group (n = 54).

Haldane Anscombe correction was applied if cells contained less than 1 observation before Pearson’s Chi-square was performed. A p-value ≤ 0.05 was considered significant *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001.

Table 2. Associations between risk factors and the total mean PHQ-9 score or total mean WEMWBS score among leprosy-affected people in southern Nepal (N = 86).

	n	Mean total PHQ-9 score (95% CI)	p-value	Mean total WEMWBS score (95% CI)	p-value
Age
≤ 50 years	25	6.9 (5.3-8.6)	0.885	48.0 (42.3-53.7)	0.690
> 50 years	61	7.2 (6.0-8.2)		49.1 (45.5-53.8)
Gender
Male	37	5.7 (4.8-6.9)	0.023*	53.8 (49.9-57.7)	0.011*
Female	49	8.1 (7.0-9.2)		45.0 (41.8-49.1)
Disability Grade
0 & 1	66	6.0 (5.0-6.6)	0.023*	50.3 (47.6-53.2)	0.069
2	20	10.7 (8.3-12.7)		43.8 (36.9-50.6)
Caste
Middle or High	23	5.5 (4.2-6.7)	0.069	52.1 (46.2-58.2)	0.069
Low	63	7.7 (6.1-8.7)		47.6 (43.8-52.2)
Marital status
Married	65	6.4 (5.5-7.2)	0.103	50.5 (47.4-53.2)	0.069
Not married	21	9.1 (6.6-11.7)		43.6 (35.6-52.0)
Mean total 5-QSI-AP score	86	1.36 (0.78-2.01)^1	0.011*	-2.61 (-4.16; -0.53)^1	0.011*

1. Regression coefficient (β) and 95% CI of mean total 5-QSI-AP score.

Bootstrapped univariate regression was performed. A p-value ≤ 0.05 was considered significant, *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001. n = number of subjects within that category. 95% CI = 95% confidence interval, PHQ-9 = Patient Health Questionnaire, WEMWBS = Warwick-Edinburgh Mental Wellbeing Scale, 5-QSI-AP = 5-Question Stigma Indicator-Affected Persons.

Table 3. Multivariate regression analysis risk factors and the total mean PHQ-9 score or total mean WEMWBS score among leprosy-affected people in southern Nepal (N = 86).

	Regression coefficient (β)	Standard error	p-value
PHQ-9
Constant	2.817	0.919	0.011
Mean total 5-QSI-AP score	1.110	0.381	0.011*
Gender
Male	Reference
Female	2.619	0.936	0.023*
Disability grade
0 & 1	Reference
2	3.763	1.577	0.046*
WEMWBS
Constant	57.667	1.822	0.011
Mean 5-QSI-AP score	-2.477	0.679	0.011*
Gender
Male	Reference
Female	-8.168	2.155	0.023*

Bootstrapped multivariate regression was performed with the risk factors identified in the bootstrapped univariate regression (table 2). The model of PHQ-9 explains 37.0% of the score (R square = 0.370) and the WEMWBS model 28.8% (R square = 0.288).

A p-value ≤ 0.05 was considered significant, *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001. n = number of subjects within that category. 95% CI = 95% confidence interval, PHQ-9 = Patient Health Questionnaire, WEMWBS = Warwick-Edinburgh Mental Wellbeing Scale, 5-QSI-AP = 5-Question Stigma Indicator-Affected Persons.