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印度一家三级护理中心肺结核患者精神疾病评估

Assessment of Psychiatric Illness among Pulmonary Tuberculosis Patients at a Tertiary Care Center in India.

作者信息

Yadav Prashant, Gupta Ashish Kumar, Gautam Aditya Kumar, Arya Sumit, Kumar Adesh, Mishra Arun Kumar, Gupta Sandeep

机构信息

Department of Respiratory Medicine, UP University of Medical Sciences, Etawah, Uttar Pradesh, India.

Department of Psychiatry, UP University of Medical Sciences, Etawah, Uttar Pradesh, India.

出版信息

Ann Afr Med. 2024 Oct 1;23(4):594-599. doi: 10.4103/aam.aam_18_24. Epub 2024 Aug 13.

Abstract

INTRODUCTION

Tuberculosis (TB) is a chronic infectious multisystemic disease caused by Mycobacterium tuberculosis and is one of the leading causes of mortality worldwide. Both common mental disorders (CMD) and TB are global public health problems that have a considerable impact on human health. Moreover, TB and CMDs share common risk factors including poverty, drug addiction, and homelessness and the coexistence of CMD and TB leads to difficult management of TB.

MATERIALS AND METHODS

This was a hospital-based longitudinal study, carried out between June 2021 and December 2022. In this study, 147 pulmonary TB patients were included as per inclusion and exclusion criteria, and psychiatric illness was evaluated by the Brief Psychiatric Rating Scale.

RESULTS

The mean age of study participants was 37.59 ± 15.37 years, there were 99 (67.3%) were male and 48 (32.7%) were female. Psychiatric illness was found in 77 (52.38%) pulmonary TB patients. Among psychiatric illness, anxiety was found in 33 (22.4%) participants and 21 (14.3%) participants had depression. Mixed anxiety and depression were found in 20 (13.6%) patients and 03 (2%) participants had severe psychosis. The association of psychiatric illness with age group and gender was not significant ( P = 0.734, 0.203, respectively). There were 105 (71.40%) patients who had <12 standard education and 42 (28.60%) had >12 standard education and their association with psychiatric illness was statistically significant ( P = 0.044). Adverse drug reactions were found among 80 (54.42%) patients and the association between adverse drug reactions and psychiatric illness was significant ( P = 0.031).

CONCLUSION

Psychiatric illness is one of the important domains to be evaluated in timely manner in TB patients and early intervention is needed for better management of the TB because the severity, social factors, and chronicity of the disease make them susceptible to develop psychiatric illness.

摘要

引言

结核病(TB)是一种由结核分枝杆菌引起的慢性传染性多系统疾病,是全球主要死因之一。常见精神障碍(CMD)和结核病都是对人类健康有重大影响的全球公共卫生问题。此外,结核病和常见精神障碍有共同的风险因素,包括贫困、药物成瘾和无家可归,而常见精神障碍与结核病并存会导致结核病治疗困难。

材料与方法

这是一项基于医院的纵向研究,于2021年6月至2022年12月进行。在本研究中,根据纳入和排除标准纳入了147例肺结核患者,并通过简明精神病评定量表评估精神疾病。

结果

研究参与者的平均年龄为37.59±15.37岁,其中99例(67.3%)为男性,48例(32.7%)为女性。77例(52.38%)肺结核患者存在精神疾病。在精神疾病中,33例(22.4%)参与者存在焦虑,21例(14.3%)参与者患有抑郁症。20例(13.6%)患者存在混合性焦虑和抑郁,3例(2%)参与者患有严重精神病。精神疾病与年龄组和性别的关联不显著(P值分别为0.734和0.203)。105例(71.40%)患者接受的正规教育年限<12年,42例(28.60%)患者接受的正规教育年限>12年,他们与精神疾病的关联具有统计学意义(P = 0.044)。80例(54.42%)患者出现药物不良反应,药物不良反应与精神疾病之间的关联显著(P = 0.031)。

结论

精神疾病是结核病患者需要及时评估的重要领域之一,由于疾病的严重性、社会因素和慢性病程使他们易患精神疾病,因此需要早期干预以更好地管理结核病。

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Ecology and evolution of Mycobacterium tuberculosis.结核分枝杆菌的生态学与进化。
Nat Rev Microbiol. 2018 Apr;16(4):202-213. doi: 10.1038/nrmicro.2018.8. Epub 2018 Feb 19.
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Clinical Aspects of Adult Tuberculosis.成人肺结核的临床方面
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