麻风病患者的抑郁和焦虑负担及其相关因素-来自印度的横断面研究。
Burden of depression and anxiety among leprosy affected and associated factors-A cross sectional study from India.
机构信息
Research Domain, The Leprosy Mission Trust India, New Delhi, India.
Counselling department, TLM Community Hospital, Vadathorasalur, Tamil Nadu, India.
出版信息
PLoS Negl Trop Dis. 2021 Jan 22;15(1):e0009030. doi: 10.1371/journal.pntd.0009030. eCollection 2021 Jan.
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.
背景
麻风病是一种被忽视的热带病（NTDs），已知会在中低收入国家造成污名和歧视。它经常导致可见的损伤，从而容易导致心理健康不佳。本研究的目的是估计受麻风病影响的人的抑郁和焦虑患病率，并确定相关因素。
方法/主要发现：在印度恰蒂斯加尔邦、马哈拉施特拉邦、西孟加拉邦和泰米尔纳德邦四个麻风病流行州的四个选定地区进行了一项多中心、横断面研究，每个州从一个地区随机选择一个区块（区的一个亚单位）。从选定的区块中，在公共卫生或转诊中心登记接受麻风病治疗的人，年龄在 18 岁以上的人分别接受 PHQ-9 和 GAD-7 问卷，以评估抑郁和焦虑情况。同时收集疾病特征，如麻风病分类、残疾等级、斑块数量和部位以及社会经济状况，以及个人数据。在总共 220 名受访者中，抑郁和焦虑症状的患病率分别为 33%（73 人）和 19%（42 人）。残疾（47%）和女性（46%）的存在与抑郁显著相关。残疾（32%）、低收入群体（27%）和低教育程度（22%）与焦虑症状显著相关。随着残疾程度的增加，患抑郁和焦虑的风险增加。
结论
研究表明，超过 30%的受麻风病影响的人存在心理健康问题，这强调了在麻风病中提供心理健康护理服务的重要性。女性、教育程度较低、社会经济地位较低以及因麻风病而存在任何程度残疾的人，都有患抑郁和/或焦虑的风险。研究得出结论，需要更多关注被确定为处于风险中的类别。
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