Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study

BACKGROUND: Depression is the most common form of mental disorder among inmates, with a prevalence much higher than in the general population. This study aims to estimate the prevalence of depression among inmates and identify factors associated with it. METHODS: This cross-sectional study was conducted in Jhumka Regional Prison, the largest prison in eastern Nepal, from September 2014 to August 2015. A total of 434 randomly selected inmates were interviewed using a semi-structured questionnaire examining socio-demographic characteristics, detention status, self-reported health problems, substance use status, and suicidal ideation. Depression was screened using the Center for Epidemiologic Studies Depression scale. Chi-square tests and multiple logistic regression analysis were applied to determine the association between depression and related variables. RESULTS: The mean age of the participants was 35.7 years (SD 13.3). The prevalence of depression among the inmates was 35.3%. Approximately 2.3% reported suicidal ideation during imprisonment and 0.9% had attempted suicide inside the prison. In bivariate analysis, depression was significantly associated with previous incarceration (OR = 1.91, 95% CI = 1.05–3.47, p = 0.033), poor self-rated health (OR = 1.75, 95% CI = 1.16–2.64, p = 0.007), frequent appointments when encountering health problems (OR = 1.66, 95% CI = 1.06–2.61, p = 0.028), suicidal ideation (OR = 4.44, 95%CI = 1.13–17.44, p = 0.038) and loss of weight (OR = 1.49, 95% CI = 1.00–2.23, p = 0.049). However, only previous incarceration (AOR = 1.97, 95% CI = 1.04–3.74, p = 0.037) and frequent appointments when encountering health problems (AOR = 1.61, 95% CI = 1.01–2.57, p = 0.046) remained significant in a multivariate model. CONCLUSIONS: This study showed a high rate of depression among inmates in Nepal. The results suggest a need for psychiatric and rehabilitative care in correctional settings to improve the health status of the inmates.