Trenton Adam J., Currier Glenn W.
Department of Psychiatry and the Department of Emergency Medicine, University of Rochester School of Medicine, Rochester, N.Y.
Prim Care Companion J Clin Psychiatry. 2001 Dec;3(6):236-243. doi: 10.4088/pcc.v03n0610.
Tuberculosis (TB) remains a leading infectious cause of mortality worldwide. While the overall prevalence of TB in the United States has declined in the general population, certain groups remain at high risk, including the homeless, those who are HIV seropositive, individuals with a history of alcohol or drug abuse, and immigrants from a country in which TB is endemic. Many recipients of psychiatric services possess 1 or more of these risk factors, and consequently TB may be overrepresented in this population. Conversely, psychiatric illness may develop subsequent to TB infection. Mood disorders seem to be particularly common in TB patients compared with those with other medical diagnoses. It is important that primary care physicians understand the high prevalence of mental illness in TB patients so that proper treatment provisions can be implemented. Likewise, it is important for psychiatrists to understand the clinical manifestations of TB so that when a patient presents with symptoms of TB proper precautions can be taken and appropriate referrals can be made. This article integrates information concerning mental illness in TB patients with diagnostic and treatment guidelines for TB. Brief suggestions are offered for the treatment of TB patients with comorbid mental illness.
结核病（TB）仍然是全球主要的感染性致死病因。在美国，尽管普通人群中结核病的总体患病率有所下降，但某些群体仍处于高风险状态，包括无家可归者、艾滋病毒血清阳性者、有酗酒或药物滥用史的人以及来自结核病流行国家的移民。许多接受精神科服务的患者具有这些风险因素中的一种或多种，因此结核病在这一人群中的比例可能过高。相反，精神疾病可能在结核菌感染后发生。与患有其他医学诊断疾病的患者相比，情绪障碍在结核病患者中似乎尤为常见。初级保健医生了解结核病患者中精神疾病的高患病率很重要，这样才能实施适当的治疗措施。同样，精神科医生了解结核病的临床表现也很重要，以便当患者出现结核病症状时能够采取适当的预防措施并进行适当的转诊。本文将有关结核病患者精神疾病的信息与结核病的诊断和治疗指南相结合。针对患有合并精神疾病的结核病患者的治疗提供了简要建议。
