Mental Health Burden and Associated Factors Among Patients With Leprosy After Treatment Completion in South West Delhi
Introduction
The psychological sequelae of leprosy extend beyond the course of disease, yet systematic mental health evaluation in post-treatment populations remains limited, particularly within urban Indian contexts. This study examined the prevalence and determinants of depression and anxiety among leprosy patients after treatment completion in South West Delhi.
Methods
A community-based cross-sectional study was conducted among 93 leprosy patients released from treatment between April 2021 and March 2024 in South West Delhi. The Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder-7 (GAD-7) scale were used to assess depression and anxiety, respectively. Impairment levels were graded by the WHO Disability Grading Classification, functional status through the Screening of Activity Limitation and Safety Awareness Scale, and the Participation Scale.
Results
The study population comprised 57 (61.3%) males and 36 (38.7%) females with a median age of 40 years. Most participants exhibited minimal psychiatric morbidity (depression: n=73,78.5%; anxiety: n=77,82.8%). Nevertheless, clinically meaningful depression (PHQ-9 ≥ 10) was seen in nine (9.7%) participants and clinically meaningful anxiety (GAD-7 ≥ 10) in seven (7.5%) participants. In multivariate linear regression, female gender (B = 1.70, 95% CI: 0.12 to 3.28, t = 2.14, p = 0.035); lower education levels: classes 9-12 (B = 2.80, 95% CI: 0.51 to 5.09, t = 2.43, p = 0.017), classes 1-8 (B = 2.32, 95% CI: 0.06 to 4.58, t = 2.04, p = 0.044), and no formal education (B = 2.78, 95% CI: 0.20 to 5.37, t = 2.14, p = 0.035); and participation restrictions (B = 5.97, 95% CI: 4.20 to 7.74, t = 6.70, p < 0.001) were significantly associated with higher depression scores (adjusted R² = 0.53, F = 11.27, p < 0.001), while just young age (< 40 years) (B = 1.51, 95% CI: 0.14 to 2.88, t = 2.19, p = 0.031) and participation restrictions (B = 4.23, 95% CI: 2.31 to 6.14, t = 4.40, p < 0.001) significantly predicted higher anxiety scores (adjusted R²= 0.31, F = 5.18, p < 0.001).
Conclusion
This study found that although most post-multi-drug therapy (MDT) leprosy patients reported minimal psychiatric morbidity, a notable proportion experienced clinically relevant depression and anxiety. Participation restrictions emerged as the strongest predictor of higher PHQ-9 and GAD-7 scores. Female gender, lower education, and activity limitations further increased depression risk, while younger age predicted higher anxiety. These findings underscore the need to integrate mental health services into the existing leprosy management protocols.