Bala Manju, Rajpoot Akhlesh, Layek Avishek, Gupta Rahul Kumar, Rathore Suyash Singh
Department of Respiratory Medicine, Soban Singh Jeena Government Institute of Medical Science and Research, Almora, Uttarakhand, India.
Department of Respiratory Medicine, Soban Singh Jeena Government Institute of Medical Science and Research, Almora, Uttarakhand, India.
Indian J Tuberc. 2025 Apr;72(2):150-156. doi: 10.1016/j.ijtb.2025.03.010. Epub 2025 Mar 11.
Tuberculosis (TB) remains a significant global health concern, affecting millions of individuals annually. While its physical manifestations and treatment protocols have been extensively studied, the psychological dimensions of TB have garnered increasing attention in recent years. This cross-sectional observational study explored the psychological aspects of TB among TB patients undergoing treatment in a tertiary care hospital.
This was a cross-sectional clinic-based descriptive study conducted on 100 patients of pulmonary TB (PTB) and 60 patients of extrapulmonary TB (EPTB). Psychological distress was assessed using General Health Questionnaire-12 (GHQ-12), and the correlations of other psychological scales, like WHO Quality of Life Brief-26 (WHOQOL-Bref-26), Patient Distress Thermometer (PDT), Depression Anxiety Stress Scale (DASS) and Coping Strategy Checklist (CSCL). Patients with a GHQ-12 score of ≥3 were considered to be experiencing psychological distress and subsequently referred to a consultant psychiatrist for a more detailed evaluation and management.
Findings revealed a high prevalence of psychological distress (GHQ-12 ≥ 3) among TB patients, 58 % of PTB patients and 60 % of EPTB patients experienced psychological distress after screening with GHQ-12; 40 % of all the PTB and EPTB patients were diagnosed with a psychiatric illness, after evaluation by the psychiatrist. Patients of PTB and EPTB almost had similar scores on GHQ-12, WHOQOL-Bref-26, PDT, CSCL, and DASS. These scores did not differ significantly between PTB and EPTB patients. The scores on all these scales (WHOQOL-Bref-26, PDT, CSCL, and DASS) in the patients of PTB and EPTB who were experiencing psychological distress (GHQ ≥3) were significantly poorer than those without psychological distress (GHQ <3).
The study sheds light on the psychological dimensions of TB. Psychological distress and psychiatric illness leading to poorer quality of life were present in a significant number of TB patients. Therefore, mental health evaluation should be incorporated into the routine management of these patients, and a brief screening tool like GHQ-12 can be of immense help.
结核病仍然是全球重大的健康问题，每年影响数百万人。虽然其身体表现和治疗方案已得到广泛研究，但近年来结核病的心理层面受到了越来越多的关注。这项横断面观察性研究探讨了在一家三级护理医院接受治疗的结核病患者的心理状况。
这是一项基于门诊的横断面描述性研究，对100例肺结核（PTB）患者和60例肺外结核（EPTB）患者进行了研究。使用一般健康问卷-12（GHQ-12）评估心理困扰，并分析其他心理量表的相关性，如世界卫生组织生活质量简表-26（WHOQOL-Bref-26）、患者困扰温度计（PDT）、抑郁焦虑压力量表（DASS）和应对策略清单（CSCL）。GHQ-12评分≥3分的患者被认为存在心理困扰，随后转介给精神科顾问进行更详细的评估和管理。
研究结果显示，结核病患者中存在心理困扰（GHQ-12≥3）的比例很高，58%的肺结核患者和60%的肺外结核患者在接受GHQ-12筛查后出现心理困扰；在精神科医生评估后，所有肺结核和肺外结核患者中有40%被诊断患有精神疾病。肺结核和肺外结核患者在GHQ-12、WHOQOL-Bref-26、PDT、CSCL和DASS量表上的得分几乎相似。这些得分在肺结核和肺外结核患者之间没有显著差异。在存在心理困扰（GHQ≥3）的肺结核和肺外结核患者中，所有这些量表（WHOQOL-Bref-26、PDT、CSCL和DASS）的得分明显低于没有心理困扰（GHQ<3）的患者。
该研究揭示了结核病的心理层面。相当数量的结核病患者存在心理困扰和精神疾病，导致生活质量下降。因此，心理健康评估应纳入这些患者的常规管理中，像GHQ-12这样的简短筛查工具可能会有很大帮助。
