Prevalence and correlates of anxiety and depression among LGBT individuals in Nepal: a cross-sectional study

BMJ Open. 2026 Apr 28;16(4):e105946. doi: 10.1136/bmjopen-2025-105946.

ABSTRACT

OBJECTIVES: Lesbian, gay, bisexual and transgender (LGBT) individuals have faced marginalisation and discrimination despite legal advancements, such as those in Nepal. While Nepal has constitutional protections for LGBT rights, the community still deals with social stigma, harassment and mental health challenges. Limited research exists on LGBT mental health in Nepal, with studies mostly focusing on sexual health. This study aims to assess the prevalence of depression and anxiety among LGBT individuals of Kathmandu Valley, focusing on the factors associated with anxiety and depression.

DESIGN: A community-based cross-sectional descriptive quantitative study.

SETTING: Conducted in urban areas of Kathmandu Valley, Nepal, from January to May 2018.

PARTICIPANTS: Data were collected from 197 LGBT individuals aged 18 and above using snowball sampling, whereas individuals unable to complete the questionnaire due to language barriers were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were depression and anxiety, assessed using the Centre for Epidemiological Studies Depression Scale and Beck Anxiety Inventory respectively. Secondary measures included sociodemographic and behavioural factors. Multivariable logistic regression analysis was performed to estimate adjusted ORs (aORs) with 95% CIs.

RESULTS: The study found 18.27% LGBT individuals were depressed and 25.38% of LGBT individuals had anxiety. Individuals from minority ethnic groups had higher odds of depression compared with Brahmin/Chhetri (aOR=4.31, 95% CI (1.02 to 18.20)). A history of suicide attempts was strongly associated with both depression (aOR=11.20, 95% CI (3.94 to 32)) and anxiety (aOR=3.27, 95% CI 1.46 to 7.33; p<0.01). Above-average self-rated health was associated with lower odds of depression (aOR=0.34, 95% CI (0.14 to 0.87)) and anxiety (aOR=0.333, 95% CI (0.149 to 0.743)).

CONCLUSIONS: A substantial proportion of LGBT individuals in Nepal experience depression and anxiety, with disparities linked to ethnicity, self-rated health and history of suicide attempts. These findings highlight the need for inclusive and culturally sensitive mental health interventions and targeted support strategies for this population. Further research using representative sampling and longitudinal designs is recommended.

PMID:42049292 | DOI:10.1136/bmjopen-2025-105946