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潜伏性结核和活动性结核患者家庭接触者的抑郁症状。

Latent TB and depressive symptoms in household contacts of persons with active TB.

机构信息

School of Social Work, University of South Florida, Tampa, FL, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA.

Department of Medical Education, Dell Medical School at the University of Texas at Austin, Austin, TX.

出版信息

Int J Tuberc Lung Dis. 2023 Sep 1;27(9):682-687. doi: 10.5588/ijtld.22.0609.

Abstract

Depression is common among persons with TB and is associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. We assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment. We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, during 2016-2018. At enrollment, HHC LTBI status was assessed using the interferon-gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) with a cut-off of <mml:math display="inline">mml:mo5. We used logistic regression to estimate the odds ratio (OR) for PHQ-9 <mml:math display="inline">mml:mo5, comparing HHCs with and without baseline LTBI. Among 921 HHCs, 374 (41.0%) had LTBI at baseline, and 69 (12.4%) of 567 HHCs had PHQ-9 <mml:math display="inline" id="im1">mml:mo5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 <mml:math display="inline" id="im2">mml:mo5 at follow-up after controlling for potential confounders (adjusted OR 1.93, 95% CI 1.09-3.39); this association was driven by greater severities of depressive symptoms. HHCs with LTBI had increased odds of depressive symptoms 1 year later. This population may benefit from mental health screening and interventions integrated into TB programs.

摘要

抑郁在结核病患者中很常见,并且与较差的临床结局相关。然而,人们对潜伏性结核感染(LTBI)与抑郁之间的关系知之甚少。我们评估了 LTBI 与接受结核病治疗患者的家庭接触者(HHC)中抑郁症状之间的关系。我们在 2016 年至 2018 年期间招募了秘鲁利马 307 名接受结核病治疗的患者的 1009 名 HHC。在入组时,使用干扰素 -γ释放试验(IGRA)评估 HHC 的 LTBI 状态。使用患者健康问卷-9(PHQ-9)在基线和 12 个月后评估抑郁症状,PHQ-9<mml:math display="inline">mml:mo5 为截断值。我们使用逻辑回归来估计 PHQ-9<mml:math display="inline">mml:mo5 的优势比(OR),比较基线时 LTBI 阳性和阴性的 HHC。在 921 名 HHC 中,374 名(41.0%)在基线时患有 LTBI,567 名 HHC 中有 69 名(12.4%)PHQ-9<mml:math display="inline" id="im1">mml:mo5。与入组时未感染 LTBI 的 HHC 相比,在控制潜在混杂因素后,LTBI 感染的 HHC 出现 PHQ-9<mml:math display="inline" id="im2">mml:mo5 的可能性几乎增加了两倍(调整后的 OR 1.93,95%CI 1.09-3.39);这种关联是由抑郁症状的严重程度增加驱动的。LTBI 感染的 HHC 一年后出现抑郁症状的可能性增加。这部分人群可能受益于纳入结核病规划的心理健康筛查和干预措施。

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本文引用的文献

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Risk Factors for Depression in Tuberculosis Patients: A Meta-Analysis.肺结核患者抑郁症的危险因素:一项荟萃分析。
Neuropsychiatr Dis Treat. 2022 Apr 11;18:847-866. doi: 10.2147/NDT.S347579. eCollection 2022.
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The Bidirectional Relationship of Depression and Inflammation: Double Trouble.抑郁和炎症的双向关系:双重麻烦。
Neuron. 2020 Jul 22;107(2):234-256. doi: 10.1016/j.neuron.2020.06.002. Epub 2020 Jun 17.
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The art of medicine: Inflamed depression.医学的艺术:炎症性抑郁症。
Lancet. 2018 Oct 6;392(10154):1189-1190. doi: 10.1016/S0140-6736(18)32356-0. Epub 2018 Oct 4.

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