Determining the prevalence of and risk factors for depressive symptoms among adults in Nepal: Findings from the Dhulikhel Heart Study
Michelle S Lam1, Annette L Fitzpatrick2, Archana Shrestha3, Biraj M Karmacharya4, Rajendra P Koju5, Deepa Rao6
1 Department of Global Health, University of Washington; Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
2 Department of Global Health; Department of Family Medicine; Department of Epidemiology, University of Washington, Seattle, Washington, USA
3 Department of Epidemiology, University of Washington, Seattle, Washington; Department of Epidemiology, Harvard University, Cambridge, Massachusetts, USA
4 Department of Global Health, University of Washington, Seattle, Washington, USA; Department of Community Medicine; Department of Community Programs, Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal
5 Department of Global Health, University of Washington, Seattle, Washington, USA; Department of Cardiology, Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal
6 Department of Global Health; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
Michelle S Lam
University of Washington Medical Center, Box 358 250, Seattle, WA 98195
Source of Support: None, Conflict of Interest: None
Context: Nepal is currently experiencing a rapid growth in noncommunicable diseases (NCDs). Depression has previously been associated with NCDs in South Asia; however, data regarding its prevalence and risk factors are lacking in Nepal.
Aims: This study aims to describe the prevalence of and risk factors for depressive symptoms in a suburban population of adults within Nepal.
Setting and Design: We conducted a cross-sectional analysis of baseline data collected from participants enrolled in the Dhulikhel Heart Study, a population-based, longitudinal cohort study investigating cardiovascular risk factors in Dhulikhel, a suburban town outside Kathmandu.
Subjects and Methods: Baseline questionnaire data from 1073 adults age 18 years and older included the Center for Epidemiologic Studies Depression Scale (CES-D). A score of 16 or greater on the CES-D has been shown to indicate major depressive symptomatology.
Statistical Analysis: Using STATA 13, we conducted Pearson's Chi-square tests and multiple logistic regressions to examine associations between the binary CES-D score and gender, age, education, marital status, body mass index, physical activity, and hypertensive status.
Results: The mean CES-D score in the sample was 11.7 (standard deviation: 5.3), with 21.3% scoring 16 or greater. Age over 60 and lack of formal education were associated with increased risk of depressive symptoms. Being physically active was associated with decreased risk of depressive symptoms.
Conclusions: The estimated prevalence of depression among adults in Dhulikhel was 21.3%. Significant risk factors for increased depressive symptoms included lack of formal education, age over 60, and physical inactivity.