Pasha Aneeta, Siddiqui Hasha, Ali Shiza, Brooks Meredith B, Maqbool Naveen R, Khan Aamir J
IRD Pakistan, Karachi, Pakistan.
Anthropology, Division of Social Sciences, The University of Chicago, Chicago, IL, USA.
Med Access Point Care. 2021 Apr 27;5:23992026211011314. doi: 10.1177/23992026211011314. eCollection 2021 Jan-Dec.
Depression and anxiety among tuberculosis (TB) patients can adversely affect TB treatment adherence and completion.
We studied whether integrating mental health services into existing TB treatment programs would reduce symptoms of depression and anxiety and improve treatment completion among patients with drug-susceptible TB.
Integrated practice units (IPUs) for TB and mental health were established within six existing TB treatment facilities in Karachi, Pakistan. Patients were screened for depression and anxiety and, if symptomatic, offered a mental health intervention consisting of at least four counseling sessions. We measured changes in reported levels of depression and anxiety symptoms from baseline following completion of counseling sessions, and rates of TB treatment completion.
Between February 2017 and June 2018, 3500 TB patients were screened for depression and anxiety. 1057 (30.2%) symptomatic patients received a baseline adherence session. 1012 enrolled for a mental health intervention received at least 1 counseling session. 522 (51.5%) reported no symptoms after four to six sessions. Symptomatic patients who completed at least four counseling sessions had higher rates of TB treatment completion than those who did not (92.9% vs 75.1%; < 0.0001).
Mental health interventions integrated within TB programs can help reduce symptoms of depression and anxiety and improve TB treatment completion.
结核病患者的抑郁和焦虑会对结核病治疗的依从性和完成情况产生不利影响。
我们研究了将心理健康服务纳入现有的结核病治疗项目是否会减轻药物敏感型结核病患者的抑郁和焦虑症状，并提高治疗完成率。
在巴基斯坦卡拉奇的六个现有的结核病治疗机构内设立了结核病与心理健康综合诊疗单元（IPUs）。对患者进行抑郁和焦虑筛查，如有症状，则提供包括至少四次咨询服务的心理健康干预。我们测量了咨询服务结束后报告的抑郁和焦虑症状水平相对于基线水平的变化，以及结核病治疗完成率。
在2017年2月至2018年6月期间，对3500名结核病患者进行了抑郁和焦虑筛查。1057名（30.2%）有症状的患者接受了基线依从性咨询。1012名报名参加心理健康干预的患者至少接受了1次咨询服务。522名（51.5%）患者在接受四至六次咨询后报告无症状。完成至少四次咨询的有症状患者的结核病治疗完成率高于未完成的患者（92.9%对75.1%；<0.0001）。
结核病项目中整合的心理健康干预措施有助于减轻抑郁和焦虑症状，并提高结核病治疗完成率。
