Shyamala K K, Naveen R Sharadha, Khatri Bidhata
Associate Professor, Dept. of Pulmonary Medicine, Dr. B.R. Ambedkar Medical College, Bengaluru, Karnataka.
Associate Professor & I/C HOD, Dept. of Psychiatry, PK Das Medical College Hospital, Vaniamkulam, Ottapalam, Palakkad, Kerala; *Corresponding Author.
J Assoc Physicians India. 2018 Dec;66(12):18-21.
Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in India. Depression among TB patients is a common comorbidity which is often unrecognised and untreated. It constitutes a major risk factor for higher default rates due to non-adherence to the treatment, thereby affecting the treatment outcome.
This study was carried out to assess the prevalence of depression and it's severity among TB patients.
It was a cross-sectional, prospective and observational study conducted in TB patients, diagnosed and registered under directly observed treatment system (DOTS) at a tertiary care hospital in Bangalore from June 2016 to October 2016. Depression was assessed using Patient Health Questionnaire (PHQ-9).
Out of the total two hundred sixty two (262) TB patients, 107 patients were found to have depression. The prevalence was found to be 40.83%. Mild to moderate depression was observed in 71.02% of the patients. Predominantly, depression was seen in the age group 20- 39 years (49.53%). Males had significant depression (p = 0.021). Patients with pulmonary TB (80.37%) were found to have higher depression than patients with extrapulmonary TB (19.62%). Depression was more during the first four months of the therapy. Significant depression was found among patients who were alcoholics (p = 0.027). There was no statistically significant association of depression with comorbidities.
There is high prevalence of depression among TB patients. It is more common in males and alcoholics. Patients who are in the first four months of the treatment are more likely to have depression. There should be regular screening of the patients with TB for psychiatric illness during the course of the treatment for better treatment compliance and outcome.
在印度，精神疾病在结核病（TB）患者中常常是一个被忽视的问题。结核病患者中的抑郁症是一种常见的合并症，常常未被识别和治疗。它是导致因不坚持治疗而出现较高违约率的主要风险因素，从而影响治疗结果。
本研究旨在评估结核病患者中抑郁症的患病率及其严重程度。
这是一项横断面、前瞻性观察性研究，于2016年6月至2016年10月在班加罗尔一家三级护理医院对按照直接观察治疗系统（DOTS）诊断和登记的结核病患者进行。使用患者健康问卷（PHQ - 9）评估抑郁症。
在总共262名结核病患者中，发现107名患者患有抑郁症。患病率为40.83%。71.02%的患者观察到轻度至中度抑郁症。主要在20 - 39岁年龄组中发现抑郁症（49.53%）。男性有明显的抑郁症（p = 0.021）。发现肺结核患者（80.37%）比肺外结核患者（19.62%）有更高的抑郁症患病率。在治疗的前四个月抑郁症更为常见。在酗酒患者中发现有明显的抑郁症（p = 0.027）。抑郁症与合并症之间没有统计学上的显著关联。
结核病患者中抑郁症患病率很高。在男性和酗酒者中更常见。处于治疗前四个月的患者更有可能患有抑郁症。在治疗过程中应定期对结核病患者进行精神疾病筛查，以提高治疗依从性和改善治疗结果。
