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Prevalence of Depression and Generalized Anxiety Disorder among Leprosy and PTB respondents

CHAPTER FIVE RESULTS

5.4 Prevalence of Depression and Generalized Anxiety Disorder among Leprosy and PTB respondents

The weighted prevalence figures for depression, generalized anxiety disorder and comorbid depression and generalized anxiety disorder for both groups are same as their current prevalence figures. This is so because 10% of those who screened negative with HADS that were administered CIDI in either group remained negative. Prevalence of depression and generalized anxiety disorders in the Leprosy respondents that had positive HADS scores were 14% and 22%

respectively compared to the PTB respondents that had prevalence of 11% and 8%, respectively, for depression and generalized anxiety disorder. Leprosy respondents had statistically higher prevalence of GAD than the tuberculosis respondents (X2 = 7.686, 0.006). Ten percent (10%) of leprosy respondents fulfilled criteria for diagnosis of both depression and generalized anxiety disorders as against 1% noted for PTB, which was statistically significant (X2 = 7.792, 0.005).

Generalized anxiety disorder and comorbid depression and generalized anxiety disorder are significantly associated with leprosy.

Table 4:-Prevalence of depression and generalized anxiety disorder among respondents with Leprosy and Pulmonary Tuberculosis (PTB)

Leprosy N = 100

PTB N = 100

Statistics

Diagnosis n (%) n (%) X2 d f p

Depression 14 (14.0) 11 (11.0) 0.411 1 0.521

Generalized Anxiety Disorder 22 (22.0) 8 (8.0) 7.686 1 0.006 Comorbid Depression and Generalized

Anxiety Disorder 10 (10.0) 1 (1.0) 7.792 1 0.005

Total Diagnosis 36 (36.0) 19(19.0)

No Diagnosis 64(64.0) 81(81.0)

Total number of participants 100(100.0) 100(100.0)

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5.4.2 Weighted prevalence of depression among leprosy respondents

The weighted prevalence of depression among leprosy respondents was 14.0% (table 4b).

Table 4b: Weighted prevalence rate of depression in leprosy a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 38 nh2 = 38

Low Scorers nl1 = 62 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 14 bhr = 24 Low Scorers clr = 0 dlr = 7 c) Weighted Data

Cases None-cases

High Scorers: a = ahr х nh1 = 14 x 38 = 14 b = bhr x nh1=24 x38 =24 nh2 38 nh2 38 Low Scorers: c = clr x nl1 = 0 x 62 = 0 d = dlr x nl1 = 7 x 62 = 62 nl2 7 nl2 7

d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (14+0)x100/(14+24+0+62) = 14%

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5.4.3 Weighted prevalence of generalized anxiety disorder among leprosy respondents The weighted prevalence of generalized anxiety disorder among leprosy respondents was 22.0%

(table 4c).

Table 4c: Weighted prevalence rate of generalized anxiety disorder in leprosy a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 38 nh2 = 38

Low Scorers nl1 = 62 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 22 bhr = 16 Low Scorers clr = 0 dlr = 7 c) Weighted Data

Cases None-cases

High Scorers: a = ahr х nh1 = 22 x 38 = 22 b = bhr x nh1=16 x38 =16 nh2 38 nh2 38

Low Scorers: c = clr x nl1 = 0 x 62 = 0 d = dlr x nl1 = 7 x 62 = 62 nl2 7 nl2 7 d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (22+0)x100/(22+16+0+62) = 22%

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5.4.4 Weighted prevalence of comorbid depression and generalized anxiety disorder among leprosy respondents

The weighted prevalence of generalized anxiety disorder among leprosy respondents was 10.0%

(table 4d).

Table 4d: Weighted prevalence rate of comorbid depression and generalized anxiety disorder in leprosy

a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 38 nh2 = 38

Low Scorers nl1 = 62 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 10 bhr = 28 Low Scorers clr = 0 dlr = 7 c) Weighted Data

Cases None-cases

High Scorers: a = ahr х nh1 = 10 x 38 = 10 b = bhr x nh1=28 x38 =28 nh2 38 nh2 38

Low Scorers: c = clr x nl1 = 0 x 62 = 0 d = dlr x nl1 = 7 x 62 = 62 nl2 7 nl2 7 d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (10+0)x100/(10+28+0+62) = 10.0%

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5.4.5 Weighted prevalence of psychiatric morbidity and HADS screening validity coefficients in leprosy patients

The weighted prevalence of psychiatric morbidity was 36%. The sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV) and misclassification rate of HADS to the weighted CIDI diagnosis were 100%, 96.9%, 94.7%, 100% and 2%, respectively.(Table 4e).

Table 4e: Weighted prevalence of psychiatric morbidity and HADS screening validity coefficients in leprosy patients

a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 =38 nh2 =38

Low Scorers nl1 = 62 nl2 =7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr =36 bhr =2 Low Scorers clr =0 dlr = 7 c) Weighted Data

Cases None-cases High Scorers: a = ahr х nh1 = 36 x 38 =36 b = bhr x nh1=2 x38 =2 nh2 38 nh2 38

Low Scorers: c = clr x nl1 = 0 x 62 = 0 d = dlr x nl1 = 7 x 62 = 62 nl2 7 nl2 7

d) Weighted prevalence=(a+c) x 100/(a+b+c+d)=(36+0)x100/(36+2+0+62)=36%

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e) Sensitivity a x 100/(a+c) = 36 x 100/(36+0)= 100%

f) Specificity d x 100/(b+d) = 62 x 100/(2+62) = 96.9%

g) PPV a x 100/(a+b) = 36 x 100/(36+2)= 94.7%

h) NPV d x 100/(c+d) = 62 x100/(0+62) =100%

i ) Misclassification (b+c) x100/(a+b+c+d)=(2+0)x100/(36+2+0+62) =2%

5.4.6 Weighted prevalence of depression among PTB respondents

The weighted prevalence of depression among PTB respondents was 11.0% (table 4f).

Table 4f: Weighted prevalence of depression in PTB a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 33 nh2 = 33

Low Scorers nl1 = 67 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 11 bhr = 22 Low Scorers clr = 0 dlr = 7 c) Weighted Data

Cases None-cases

High Scorers: a = ahr х nh1 = 11 x 33 = 11 b = bhr x nh1=22 x33 =22 nh2 33 nh2 33

Low Scorers: c = clr x nl1 = 0 x 67 = 0 d = dlr x nl1 = 7 x 67 = 67 nl2 7 nl2 7

d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (11+0)x100/(11+22+0+67) = 11.0%

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5.4.7 Weighted prevalence of generalized anxiety disorder among PTB respondents The weighted prevalence of generalized anxiety disorder among leprosy respondents was 8.0%

(table 4g).

Table 4g: Weighted prevalence rate of generalized anxiety disorder in PTB a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 33 nh2 = 33

Low Scorers nl1 = 67 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 8 bhr = 25 Low Scorers clr = 0 dlr = 7 c) Weighted Data

Cases None-cases High Scorers: a = ahr х nh1 = 8 x 38 = 8 b = bhr x nh1=25 x33 =25 nh2 38 nh2 33

Low Scorers: c = clr x nl1 = 0 x 67 = 0 d = dlr x nl1 = 7 x 67 = 67

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nl2 7 nl2 7 d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (8+0)x100/(8+25+0+67) = 8.0%

5.4.8 Weighted prevalence of comorbid depression and generalized anxiety disorder among PTB respondents

The weighted prevalence of comorbid depression and generalized anxiety disorder among PTB respondents was 1.0% (table 4h).

Table 4h: Weighted prevalence rate of comorbid depression and generalized anxiety disorder in PTB

a)No. of people in each stage of assessment

With HADS Administered CIDI High Scorers nh1 = 33 nh2 = 33

Low Scorers nl1 = 67 nl2 = 7 b) Results of second stage of assessment

Cases None-cases High Scorers ahr = 1 bhr = 32 Low Scorers clr = 0 dlr = 7 c) Weighted Data

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Cases None-cases High Scorers: a = ahr х nh1 = 1 x 33 = 1 b = bhr x nh1=32 x33 =32 nh2 33 nh2 33

Low Scorers: c = clr x nl1 = 0 x 67 = 0 d = dlr x nl1 = 7 x 67 = 67 nl2 7 nl2 7

d) Weighted prevalence = (a+c) x 100/(a+b+c+d) = (1+0)x100/(1+32+0+67) = 1.0%