Depression among TB patients and associated factors in Kathmandu Valley, Nepal

Abstract

Introduction When tuberculosis (TB) and depression co-occur, there is greater risk for comorbidities, disability, suffering, and health-related costs. Depression is also associated with poor treatment adherence in patients with TB. The major aim of this study was to assess the symptoms of depression and associated factors among TB patients currently receiving directly observed treatment short-course (DOTS) treatment. Methods A cross-sectional study was conducted among TB patients currently undergoing treatment in 27 DOTS centers in three districts of Kathmandu Valley. The study included 250 TB patients within 2 months of treatment initiation, aged 18 years and above. The previously validated Nepali Patient Health Questionnaire (PHQ-9) was used to screen for depression and semi-structured interviews were conducted to collect socio-demographic information and other factors related to TB and/or depression. Data analysis was conducted using IBM SPSS Statistics version 20. Results The study found the mean PHQ Score to be 2.84 (s.d. 4.92, range 0–25). Among the respondents, 10% (n = 25) had PHQ-9 scores ⩾10, suggestive of probable depression. Multivariate linear regression indicated that depressive symptoms were significantly associated with being separated/widowed/divorced (p = 0.000) and having lower education (0.003). In addition, smoking (p = 0.02), alcohol use (p = 0.001), and experience of side effects from TB medications (p = 0.001) were risk factors for higher PHQ-9 scores. Conclusions Our findings suggest that patients on TB treatment have higher risk of depression and efforts should be made by the National Tuberculosis Program to address this issue.

Managing Comorbidities, Determinants and Disability at Start and End of TB Treatment under Routine Program Conditions in China

“…Fourth, we found few patients with mental health disorders in contrast to a systematic review that identified mental health disorders in nearly a quarter of TB patients [ 8 ]. Anxiety and depression seem to be particularly common if patients are properly screened [ 23 , 24 ]. In our study we did not use a systematic screening tool such as the validated Patient Health Questionnaire (PHQ-9) [ 25 ] and it is likely that we underestimated the prevalence of mental health disorder.…”

The Effects of Acceptance and Commitment Therapy on Psychosocial Impact and Adherence of Multidrug-Resistant Tuberculosis Patients

“…This result agrees with a study randomly controlled trial showing that ACT could reduce patients’ depression during their treatment. 24 Depression in clients with tuberculosis can be influenced by various factors, including side effects of treatment, low levels of education, smoking and alcohol, and separation (divorce). The results of this study indicate that as many as 70.9% of MDR-TB patients do not work.…”

Depression, Anxiety, and Cigarette Smoking Among Patients with Tuberculosis

“…This is consistent with data showing men in Botswana are more likely to smoke than women (Ritchie, 2019). Patients diagnosed with TB have reported both depressive symptoms (Rizvi, 2016; Shrestha et al, 2020) and smoking during treatment of TB (Altet et al, 2017; Leung et al, 2015), with both potentially leading to reduced treatment success. In addition to the hypothesis that this relationship could be bidirectional, another hypothesis for the association between depressive symptoms and smoking is the desire to self-medicate.…”