结核病与心理健康双重负担：古吉拉特邦结核病患者焦虑和抑郁的患病率及相关因素

Dual burden of TB and mental ill-health: Prevalence and associated factors of anxiety and depression among TB patients in Gujarat.

作者信息

Chauhan Ajay, Pandya Apurvakumar, Bhatt Deepti, Salaliya Vibha, Trivedi Rutu, Kapadia Dixit, Shukla Prachi, Shah Amar, Chaudhary Siddharth, Joshi Chandrashekhar, Pandey Vivekanand

机构信息

Hospital for Mental Health, Ahmedabad, Gujarat, India.

Parul Institute of Public Health, Parul University, Vadodara, Gujarat, India.

出版信息

J Family Med Prim Care. 2024 Dec;13(12):5615-5620. doi: 10.4103/jfmpc.jfmpc_532_24. Epub 2024 Dec 9.

DOI:10.4103/jfmpc.jfmpc_532_24

PMID:39790810

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11709073/

Abstract

CONTEXT

The coexistence of tuberculosis (TB) and mental disorder presents a daunting public health challenge. Studies suggest that TB patients often experience co-morbid mental health problems, highlighting a dual burden of illness. However, due to limited research in Gujarat, we cannot draw definitive conclusions or develop targeted mental health interventions for this population.

AIM

To investigate the prevalence of depression, anxiety, and associated factors among TB patients from Gandhinagar and Surat cities in Gujarat, India.

SETTINGS AND DESIGN

The cross-sectional research was conducted in two cities in Gujarat, Gandhinagar and Surat, between October 2021 and July 2023.

METHODS AND MATERIAL

Demographic information, anxiety and depressive symptoms, and perceived TB stigma were assessed at baseline (within 1 month of treatment initiation) and at the endpoint (6 months posttreatment) using a self-constructed tool for assessing risk factors and standardized instruments, namely, the Patient Health Questionnaire-4, and the Perceived TB Stigma Scale (12 items).

RESULTS

The study population had a mean age of 31.57 ± 12.34 years. The prevalence of anxiety and depression symptoms was found to be 10.5% (749) and 5% (359), respectively, at the baseline. TB patients with high perceived TB stigma and who had been sick for over six months were 3.1 times more likely to experience anxiety symptoms (Adjusted Odds Ratio (AOR) = 3.10, 95% CI: 2.22, 4.23) and 1.6 times more likely to experience symptoms of depression (Adjusted Odds Ratio (AOR) = 1.60, 95% CI: 1.12, 2.53). Gender, occupation, and socioeconomic level were significantly associated with both anxiety and depression ( < 0.05). Being single (AOR: 3.29; 95% CI: 2.45-7.53), low socioeconomic status (AOR: 5.41; 95% CI: 2.44-7.97), and being on TB treatment (AOR: 4.35; 95% CI: 1.83-15.65) were strongly associated anxiety and depressive symptoms.

CONCLUSION

The findings of the current study indicate that TB patients experience a considerable burden of symptoms of both anxiety and depression. It highlights the need for incorporating mental healthcare support within TB care programmes.

摘要

背景

结核病（TB）与精神障碍并存带来了严峻的公共卫生挑战。研究表明，结核病患者常常伴有心理健康问题，凸显了疾病的双重负担。然而，由于古吉拉特邦的研究有限，我们无法得出明确结论或为该人群制定有针对性的心理健康干预措施。

目的

调查印度古吉拉特邦甘地讷格尔市和苏拉特市结核病患者中抑郁症、焦虑症及相关因素的患病率。

设置与设计

2021年10月至2023年7月期间，在古吉拉特邦的两个城市甘地讷格尔和苏拉特进行了横断面研究。

方法与材料

使用自行构建的风险因素评估工具以及标准化量表，即患者健康问卷 - 4和结核病耻辱感量表（12项），在基线（治疗开始后1个月内）和终点（治疗后6个月）评估人口统计学信息、焦虑和抑郁症状以及感知到的结核病耻辱感。

结果

研究人群的平均年龄为31.57 ± 12.34岁。在基线时，焦虑和抑郁症状的患病率分别为10.5%（749例）和5%（359例）。结核病耻辱感高且患病超过六个月的结核病患者出现焦虑症状的可能性高3.1倍（调整优势比（AOR） = 3.10，95%置信区间：2.22，4.23），出现抑郁症状的可能性高1.6倍（调整优势比（AOR） = 1.60，95%置信区间：1.12，2.53）。性别、职业和社会经济水平与焦虑和抑郁均显著相关（<0.05）。单身（AOR：3.29；95%置信区间：2.45 - 7.53）、社会经济地位低（AOR：5.41；95%置信区间：2.44 - 7.97）以及正在接受结核病治疗（AOR：4.35；95%置信区间：1.83 - 15.65）与焦虑和抑郁症状密切相关。