{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:04:38Z","timestamp":1787169878077,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In developing countries like India, literature on the destitute primarily addresses their economic and livelihood vulnerabilities, often overlooking their mental health. Depression, which contributes to the global burden of disease, is a chronic and prevalent mental health condition. Most destitute populations, identified by the Multidimensional Poverty Index, are concentrated in low-income and lower-middle-income countries, with India hosting the largest destitute population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This paper examines the prevalence of depression among Kerala\u2019s destitute population. Data were collected from 440 respondents via stratified sampling, drawn from the Destitute Free Kerala project, a state government initiative aimed at eradicating destitution, with participants selected from three geographically representative districts: Alappuzha, Kottayam, and Idukki. The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) and a study-specific questionnaire were used. Analysis employed univariate and multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean CES-D score was 21.80 (SD 5.55) with a median of 21.0, indicating a high prevalence of depression within the studied population. Variables significantly associated with depression included sudden health shocks (AOR = 3.44, 95% CI [2.10, 5.64],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), chronic health problems (AOR = 3.70, 95% CI [2.22, 6.17],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), education level (AOR = 0.67, 95% CI [0.44, 1.01],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.056 for high school and above compared to primary education or below), and marital status (AOR = 3.65, 95% CI [1.64, 8.13],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001 for married compared to unmarried individuals).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Findings underscore the need for robust mental health components in policies and interventions targeting this vulnerable, highly deprived population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijcm.ijcm_462_24","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T16:00:15Z","timestamp":1753804815000},"page":"822-827","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unveiling the Hidden Burden: Prevalence of Depression among the Destitute in Kerala, India"],"prefix":"10.4103","volume":"50","author":[{"given":"Neenumol","family":"Babu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveenkumar","family":"Kodali","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Central 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