Samal Janmejaya, Dehury Ranjit Kumar, Thomas M Benson, Singh Hari
School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India.
School of Management Studies, University of Hyderabad, Hyderabad, Telangana, India.
Discov Ment Health. 2025 Jul 12;5(1):104. doi: 10.1007/s44192-025-00248-9.
TB and common mental disorders pose significant global health challenges that considerably impact human health. The combination of depression with TB can lead to a poor quality of life, low medication adherence, progression to drug-resistant tuberculosis, and ultimately, mortality.
This study aimed to estimate the pooled prevalence of depression in TB patients and identify the predictors of depression in this population in India.
The preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for reporting this systematic review and meta-analysis. Data were extracted from October to December 2024 using the PUBMED, Scopus, EMBASE, and DOAJ databases. A total of 25 articles were selected, and the included articles underwent quality assessment using the Joanna Briggs Institute Critical Appraisal checklist. The pooled prevalence of depression in TB patients was estimated at a 95% confidence interval using a random effects model, assuming potential heterogeneity. STATA 18 (Stata Corp LLC, College Station, TX, USA) was used for analysis.
The total sample across 25 studies included 12,033 (Mean(SD) = 481(1377), Median = 169, IQR = 106-302). The pooled prevalence of depression in TB patients in India was estimated at 37% (95% CI: 26- 49%). A subgroup analysis based on the types of TB cases indicated that the prevalence of depression in different kinds of TB cases did not vary substantially, with 39% (95% CI: 26- 54%) in both Drug-Resistant (DR) and Drug-Sensitive (DS) Tuberculosis (TB) cases, followed by DR-TB cases [36% (95% CI: 09-68%)] and DS-TB cases [32% (95% CI: 14- 53%)]. Of the nine assessment tools used to assess depression, the pooled prevalence utilising the Patient Health Questionnaire (PHQ)-9 tool was highest [43% (95% CI: 31-56%)]. There was considerable heterogeneity (I = 99.10%) observed in the random-effects model. Factors associated with depression in TB patients included gender, demographics, education, occupation, marital and relationship issues, religion, socio-economic status, habitat, disease-related factors, treatment-related factors, and social and Behavioural factors.
The study found that over one-third of TB patients experienced depression. The coexistence of depression and TB constitutes a significant public health issue that needs addressing at both the community and health facility levels.
结核病和常见精神障碍给全球健康带来了重大挑战，对人类健康产生了相当大的影响。抑郁症与结核病并存会导致生活质量低下、药物依从性差、发展为耐多药结核病，并最终导致死亡。
本研究旨在估计印度结核病患者中抑郁症的合并患病率，并确定该人群中抑郁症的预测因素。
本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南进行报告。2024年10月至12月期间，使用PUBMED、Scopus、EMBASE和DOAJ数据库提取数据。共筛选出25篇文章，并使用乔安娜·布里格斯研究所的批判性评价清单对纳入的文章进行质量评估。采用随机效应模型，在95%置信区间内估计结核病患者抑郁症的合并患病率，假定存在潜在异质性。使用STATA 18（美国德克萨斯州大学站Stata公司）进行分析。
25项研究的总样本量为12,033例（均值（标准差）=481（1377），中位数=169，四分位间距=106 - 302）。印度结核病患者抑郁症的合并患病率估计为37%（95%置信区间：26% - 49%）。基于结核病病例类型的亚组分析表明，不同类型结核病病例中抑郁症的患病率差异不大，耐多药（DR）和敏感（DS）结核病病例中的患病率均为39%（95%置信区间：26% - 54%），其次是耐多药结核病病例[36%（95%置信区间：09% - 68%）]和敏感结核病病例[32%（95%置信区间：14% - 53%）]。在用于评估抑郁症的9种评估工具中，使用患者健康问卷（PHQ）-9工具得出的合并患病率最高[43%（95%置信区间：31% - 56%）]。随机效应模型中观察到相当大的异质性（I = 99.10%）。与结核病患者抑郁症相关的因素包括性别、人口统计学、教育程度,职业、婚姻和关系问题、宗教、社会经济地位、居住环境、疾病相关因素、治疗相关因素以及社会和行为因素。
该研究发现超过三分之一的结核病患者患有抑郁症。抑郁症与结核病并存是一个重大的公共卫生问题，需要在社区和医疗机构层面加以解决。
