title: Depressive status of leprosy patients in Bangladesh: association with self-perception of stigma.
abstract: Stigmatization by the general population and their negative attitudes towards leprosy negatively impacts on patients' mental health, and so too does patients' perception of that stigma. The objective of this present study is to assess the depressive status of leprosy patients, the patient perception of that stigma, and its association with their depressive status in Dhaka, Bangladesh. Subjects were 140 patients, and a selected comparison group of 135 local people without any chronic diseases. To evaluate depressive status, the Center for Epidemiologic Studies Depression scale (CES-D) Bengali version was applied. The patient group's depressive status was significantly more severe than that of the comparison group. Depressive status of those who answered affirmatively was significantly more severe than that of those who answered negatively for three responses to questions: 1) 'I have been physically attacked by people', 2) 'I feel people regard me as strange' and 3) 'I have been refused the purchase of something by a shopkeeper'. The results showed that the depressive status in leprosy patients was greater than that of the general public. Further, actual experiences of discrimination based on stigma associated with the depressive status of leprosy patients. Mental health care for patients, regulation of discriminatory action and education that would decrease social stigma among the general population, especially people who might often have contact with patients, seem necessary to improve the mental health of Bangladeshi leprosy patients.
authors.affiliation: Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Japan. tsutsumi@gakushikai.jp
authors.forename: Atsuro
authors.initials: A
authors.lastname: Tsutsumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Izutsu
authors.forename: M D
authors.initials: MD
authors.lastname: Akramul Islam
authors.forename: Jalal Uddin
authors.initials: JU
authors.lastname: Amed
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakahara
authors.forename: Fumie
authors.initials: F
authors.lastname: Takagi
authors.forename: Susumu
authors.initials: S
authors.lastname: Wakai
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007918:Leprosy / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D012016:Reference Values; D012649:Self Concept; D012720:Severity of Illness Index; D017678:Sex Distribution; D012803:Sick Role; D012917:Social Adjustment; D018709:Statistics, Nonparametric; D013240:Stereotyping