Psychiatric Co-Morbidity and its Associated Risk Factors among Tuberculosis Patients

Abstract

Aim: To assess psychiatric co-morbidity (i.e., depression and anxiety) and its associated risk factors among Multidrug/Rifampicin Resistant Tuberculosis (MDR/RR-TB) patients. Methods: It was an analytical cross-sectional study carried out in Department of Chest Medicine, Jinnah Post Graduate Medical Centre from February to August, 2015. Eighty diagnosed and registered patients of MDR/RR-TB, able to comprehend Urdu language, between the age range of 18 to 60 years were approached by using convenient sampling technique. Psychiatric co-morbidity i.e., depression and anxiety were assessed by using the Urdu adapted version of Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD – 7). Results: By applying the standard cut off score of 10 or more on PHQ-9 and GAD-7, the frequency of depression was 58 (72.5%) and for anxiety it was 53 (66.25%) out of 80 MDR/RR-TB patients. The multivariant analysis, intensive phase of TB treatment (OR = 3.02; 95% CI = 0.97-9.41) was found to be significantly associated with depression by using PHQ-9 and age group of 18 to 30 years (OR=0.156; 95% CI= 0.02-0.86), pulmonary TB (OR=6.33e+7; 95% CI=0.00-inf) and intensive phase of treatment (OR= 3.892; 95% CI=1.14-13.20) were significantly associated with anxiety by using GAD-7. Conclusion: Frequency of psychiatric co-morbidity was higher among MDR/RR-TB patients. Age group of 18 to 30 years, pulmonary TB and intensive phase of treatment were found to be the risk factors for depression and anxiety among TB patients. Psycho-social factors are strong factors in the successful treatment of tuberculosis. Early detection and proper management of psychiatric co-morbidity during the treatment of MDR-TB needs special attention. Keywords: Anxiety, Depression, Drug resistance, Multidrug resistance tuberculosis, psychiatric co-morbidity,