无形的代价：揭示印度古吉拉特邦肺结核（TB）患者及其家庭中抑郁症和焦虑症的患病率及预测因素

The Invisible Toll: Unveiling the Prevalence and Predictors of Depression and Anxiety Among Pulmonary Tuberculosis (TB) Patients and Their Households in Gujarat, India.

作者信息

Patel Nirmal, Patel Harita, Varu Jay, Gandhi Rohankumar, Murugan Yogesh

机构信息

Preventive Medicine, Guru Govind Sinh Government Hospital, Jamnagar, IND.

Neuro-psychiatry, Gujarat Medical Education and Research Society Medical College, Valsad, Valsad, IND.

出版信息

Cureus. 2024 Jul 20;16(7):e65015. doi: 10.7759/cureus.65015. eCollection 2024 Jul.

DOI:10.7759/cureus.65015

PMID:39165433

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11333847/

Abstract

BACKGROUND

Tuberculosis (TB) imposes a substantial physical and psychological burden on patients and their families. This study aimed to investigate the prevalence and predictors of depression and anxiety among pulmonary TB patients and their household contacts in Jamnagar, Gujarat, India.

MATERIALS AND METHODS

A cross-sectional study was conducted at TB units (TUs) in Jamnagar, Gujarat. Trained research assistants interviewed 272 pulmonary TB patients and 544 household contacts using structured questionnaires. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Sociodemographic, clinical, and psychosocial factors (stigma and social support) were evaluated. Logistic regression analyses were performed to identify predictors of depression and anxiety. A p-value of < 0.05 was considered statistically significant for all analyses in this study.

RESULTS

Out of 272 TB patients and 544 household contacts, the prevalence of depression was 98 (36.0%) and 135 (24.8%) (p=0.001). Anxiety was present in 85 (31.3%) of TB patients and 112 (20.6%) of household contacts (p<0.001). For TB patients, low household income (AOR=2.1, 95% CI: 1.9-4.3), low social support (AOR=0.84, 95% CI: 0.6-0.9), and high perceived stigma (AOR=2.3, 95% CI: 1.3-4.5) were independently associated with depression. Among household contacts, similar factors were identified, including low household income (AOR=1.7, 95% CI: 1.6-2.9), low social support (AOR=0.88, 95% CI: 0.6-0.9), and high perceived stigma (AOR=1.80, 95% CI: 1.1-2.3).

CONCLUSION

Depression and anxiety are highly prevalent among pulmonary TB patients and their household contacts in Gujarat, India. Low socioeconomic status, lack of social support, and TB-related stigma emerged as significant predictors of these mental health conditions, underscoring the need for integrated, multidisciplinary interventions to address the psychological impact of TB on patients and their families.

摘要

背景

结核病给患者及其家庭带来了沉重的身心负担。本研究旨在调查印度古吉拉特邦贾姆讷格尔市肺结核患者及其家庭接触者中抑郁症和焦虑症的患病率及预测因素。

材料与方法

在古吉拉特邦贾姆讷格尔市的结核病治疗单位开展了一项横断面研究。经过培训的研究助理使用结构化问卷对272名肺结核患者和544名家庭接触者进行了访谈。分别使用患者健康问卷-9（PHQ-9）和汉密尔顿焦虑量表（HAM-A）评估抑郁症和焦虑症。评估了社会人口学、临床和心理社会因素（耻辱感和社会支持）。进行逻辑回归分析以确定抑郁症和焦虑症的预测因素。本研究所有分析中，p值<0.05被认为具有统计学意义。

结果

在272名结核病患者和544名家庭接触者中，抑郁症患病率分别为98例（36.0%）和135例（24.8%）（p = 0.001）。结核病患者中有85例（31.3%）存在焦虑症，家庭接触者中有112例（20.6%）存在焦虑症（p<0.001）。对于结核病患者，家庭收入低（比值比[AOR]=2.1，95%置信区间[CI]：1.9 - 4.3）、社会支持低（AOR = 0.84，95% CI：0.6 - 0.9）和耻辱感高（AOR = 2.3，95% CI：1.3 - 4.5）与抑郁症独立相关。在家庭接触者中，也发现了类似因素，包括家庭收入低（AOR = 1.7，95% CI：1.6 - 2.9）、社会支持低（AOR = 0.88，95% CI：0.6 - 0.9）和耻辱感高（AOR = 1.80，95% CI：1.1 - 2.3）。