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埃塞俄比亚南部沃莱塔索多市沃莱塔索多大学医院和索多健康中心结核病患者中抑郁和焦虑的患病率及其相关因素,横断面研究

Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, Cross sectional study.

作者信息

Duko Bereket, Gebeyehu Abebaw, Ayano Getnet

机构信息

Department of Psychiatry, College of Medicine and Health Sciences, Hawassa University, P.O.Box 1560, Hawassa, Ethiopia.

Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Psychiatry. 2015 Sep 14;15:214. doi: 10.1186/s12888-015-0598-3.

Abstract

BACKGROUND

Anxiety and depression are frequently and highly occurring mental disorders in patients with tuberculosis. When depression and anxiety co-morbid with tuberculosis, it leads to poor adherence to anti TB medication, which is important barrier to global control of tuberculosis & increases the risk of morbidity and mortality due to TB. Cross sectional study was conducted to assess prevalence and correlates of depression and anxiety among patients with TB at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, Ethiopia.

METHODS

Institution based cross-sectional study was conducted in 2014.A total of 417 TB patients, who had regular follow up at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, were recruited to assess depression and anxiety and its associated correlates. Depression and anxiety were assessed through face to face interviews by trained psychiatry nurses using the hospital anxiety and depression scale (HADS). Correlates for depression and anxiety were assessed using a structured questionnaire, Oslo social support scale and TB stigma Scale.

RESULTS

The prevalence of depression and anxiety among patients with TB were 43.4% (181) and 41.5% (173) respectively. When we adjusted for the effect of potential confounding variables, patients who had co-morbid HIV infection [AOR = 5.90,(95% CI: 2.34,15.93)], poor social support [AOR = 18.06, (95% CI:11.21,25.45)] & perceived TB stigma [AOR = 10.86, (95% CI:10.26,23.47)] were more likely to have depression as compared to individuals who had no co-morbid HIV infection, good social support and no perceived TB stigma respectively. Patients who had co-morbid HIV infection [AOR = 9.61,(95% CI:3.56,25.96)], poor social support [AOR = 8.93,(95% CI: 5.01,15.94)], perceived TB stigma [AOR = 3.11,(95% CI:1.78,5.42)], being female [AOR = 1.72 (95% CI: 1.06, 2.95)], current substance use[AOR = 4.88, (95% CI: 1.79, 13.28)] and being on intensive phase of TB treatment [AOR = 1.91, (95% CI: 1.08, 3.39)] were more likely to have anxiety as compared to individuals who had no co-morbid HIV infection, good social support, no perceived TB stigma, being male and being on continuous phase of TB treatment respectively.

CONCLUSION

Developing guidelines and training of health workers in TB clinics is useful to screen and treat depression and anxiety among TB patients.

摘要

背景

焦虑和抑郁是结核病患者中频繁且高发的精神障碍。当抑郁和焦虑与结核病共病时,会导致抗结核药物治疗依从性差,这是全球结核病控制的重要障碍,并增加了结核病导致的发病和死亡风险。在埃塞俄比亚沃莱塔索多的沃莱塔索多大学医院和索多健康中心,开展了一项横断面研究,以评估结核病患者中抑郁和焦虑的患病率及其相关因素。

方法

2014年进行了一项基于机构的横断面研究。总共招募了417名在埃塞俄比亚南部沃莱塔索多的沃莱塔索多大学医院和索多健康中心接受定期随访的结核病患者,以评估抑郁、焦虑及其相关因素。抑郁和焦虑通过经过培训的精神科护士使用医院焦虑抑郁量表(HADS)进行面对面访谈来评估。使用结构化问卷、奥斯陆社会支持量表和结核病耻辱感量表评估抑郁和焦虑的相关因素。

结果

结核病患者中抑郁和焦虑的患病率分别为43.4%(181例)和41.5%(173例)。在对潜在混杂变量的影响进行调整后,与未合并艾滋病毒感染、社会支持良好且无结核病耻辱感的个体相比,合并艾滋病毒感染的患者[AOR = 5.90,(95%CI:2.34,15.93)]、社会支持差的患者[AOR = 18.06,(95%CI:11.21,25.45)]以及有结核病耻辱感的患者[AOR = 10.86,(95%CI:10.26,23.47)]更易患抑郁症。与未合并艾滋病毒感染、社会支持良好、无结核病耻辱感、男性且处于结核病治疗持续期的个体相比,合并艾滋病毒感染的患者[AOR = 9.61,(95%CI:3.56,25.96)]、社会支持差的患者[AOR = 8.93,(95%CI:5.01,15.94)]、有结核病耻辱感的患者[AOR = 3.11,(95%CI:1.78,5.42)]、女性[AOR = 1.72(95%CI:1.06,2.95)]、当前使用药物者[AOR = 4.88,(95%CI:1.79,13.28)]以及处于结核病治疗强化期的患者[AOR = 1.91,(95%CI:1.08,3.39)]更易患焦虑症。

结论

制定指南并对结核病诊所的医护人员进行培训,有助于筛查和治疗结核病患者中的抑郁和焦虑。

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