Psychosocial Impact of Leprosy with and without Deformity

A BSTRACT Background: Leprosy is known as curse to mankind due to visible deformity and disfigurement caused by it. Disfigurement and deformities are associated with social stigma and poor mental health. The bidirectional relationship between poor mental health, poor compliance, and worse outcomes of disease leading to deformities is worth exploring. Materials and Methods: A hospital-based liaison study between the Dermatology and Psychiatry departments was undertaken after approval from the Institutional Ethics Committee. A cross-sectional Psychosocial assessment of consecutive leprosy patients in an outpatient clinic was done by the Psychiatrist clinically, and using DASS 21, WHO Quality of Life scale, and perceived social support scale (PSSS) were used for the assessment and were correlated with socio-demographic factors and illness parameters like the type of leprosy and presence of deformity. Results of descriptive and analytical statistics are discussed. Results and Discussion: The study population consisted of 81 persons affected with Hansen’s disease, out of which 12 patients had deformities, the commonest being clawing of the hand (58%). Out of these 81 patients, 78 had multibacillary and 3 had paucibacillary leprosy. Patients of extremes of ages and illiterate ones commonly had poor mental health as measured by DASS score - 48.1% had scores above the cut-off. Deformities were a significant predictor of poor mental health ( P = 0.001). Lower perceived social support and poor quality of life were significantly associated with higher DASS scores, signifying higher psychiatric morbidity. Conclusion: The Mental health of leprosy patients with deformities was significantly poor as per assessment using DASS. Poor perceived social support often led to anxiety, Depression, and poor quality of life. The effect of psychiatric intervention on disease outcome and compliance with treatment needs to be studied. Counseling by a treating team is necessary for compliance and enhancing social support.