Syndemic Burden: Bridging the gap between Tuberculosis and Mental Health Care for Integrated Patient-Centered Solutions – a comprehensive review

Abstract

Introduction: Mental health issues are prevalent, yet their treatment remains inadequate. Tuberculosis presents substantial mental health challenges. Their co-occurrence is a frequent phenomenon. However, the integration of mental health professionals or services is not a common practice. Purpose: To review the evidence about the relation between tuberculosis and mental health, and its consequences concerning the implementation of policies and services. Methodology: We conducted a comprehensive review using the MeSH terms "Tuberculosis" and "Mental Health" on PubMed, spanning from 2011 to December 2021. We identified and assessed systematic reviews, regular reviews, scoping review and meta-analyses for their appropriateness and relevance. Results: A total of 341 studies were accessed for eligibility and 19 studies were included. Mental disorders and tuberculosis are frequent comorbidities. Their relation is commonly described as “syndemic”. Shared risk factors, social vulnerabilities, and upstream social determinants are prevalent in both conditions. There is a potential for the integration of both conditions into policy and service organization. Conclusions: Mental disorders treatment gap could be shortened by addressing mental health problems among TB patients. The WHO Global End TB Strategy prioritizes integrated patient-centered care, and fostering collaborative partnerships between tuberculosis and mental health services could enhance its implementation