Abstract
OBJECTIVE: To assess the prevalence of depression and its associated factors among individuals with disabilities. DESIGN: Cross-sectional study. SETTING: Community-based study conducted in Ilam municipality, Nepal, from October to November 2019. PARTICIPANTS: The study was conducted among 164 people with physical, hearing and vision-related disabilities. Participants were selected through a simple random sampling method using the sampling frame obtained from Ilam municipality. MAIN OUTCOME MEASURE: Depression and its associated factors among people with disabilities. Depression was assessed via a validated Nepali version of the Hospital Anxiety and Depression Scale. Data collection was based on a pretested structured questionnaire. RESULTS: The prevalence of depression was 39% among people with disabilities, and 29.9% of the respondents were in borderline depression. In an unadjusted analysis, depression was significantly (p<0.05) associated with comorbidities, absence of medical intervention, severe disabilities and disabilities acquired at birth. After adjusting for individual-level factors (age, sex, education, employment and physical activities), the level of disability and treatment accessibility were significantly associated with depression. After adjusting for family and community-level factors (economic status, experience of violence and social participation), depression remained significantly associated (p<0.05) with having comorbidities, absence of medical intervention and presence of very severe disabilities. When adjusting for both individual-level and community-level factors, the level of disability continued to show a significant association with depression (OR 6.36 (moderate vs mild), 2.11 (severe vs mild) and 13.3 (very severe vs mild), overall p-value of 0.045). Across all three adjusted models, the level of disability was significantly associated with depression (p<0.05). CONCLUSION: Depression is one of the major global public health concerns, with people with disabilities being particularly vulnerable. Ensuring the health and well-being of people with disabilities requires focused attention and strategic planning, emphasising disease prevention, health promotion and improved access to care.