Psychiatric Morbidity and Other Factors Affecting Treatment Adherence in Pulmonary Tuberculosis Patients

Abstract

As the overall prevalence of TB remains high among certain population groups, there is growing awareness of psychiatric comorbidity, especially depression and its role in the outcome of the disease. The paper attempts a holistic approach to the effects of psychiatric comorbidity to the natural history of tuberculosis. In order to investigate factors associated with medication nonadherence among patients suffering from tuberculosis, with emphasis on psychopathology as a major barrier to treatment adherence, we performed a systematic review of the literature on epidemiological data and past medical reviews from an historical perspective, followed by theoretical considerations upon the relationship between psychiatric disorders and tuberculosis. Studies reporting high prevalence rates of psychiatric comorbidity, especially depression, as well as specific psychological reactions and disease perceptions and reviews indicating psychiatric complications as adverse effects of anti-TB medication were included. In sum, data concerning factors affecting medication nonadherence among TB patients suggested that better management of comorbid conditions, especially depression, could improve the adherence rates, serving as a framework for the effective control of tuberculosis, but further studies are necessary to identify the optimal way to address such issues among these patients.

Depression and its Associated Factors with Multidrug-Resistant Tuberculosis at Baseline

“…Psychiatric problems such as depression can significantly affect patient quality of life, as well as physician's approach toward MDR-TB therapy. Consequently, effective management of depression is critical not only for desired patient outcome, but also for patient's overall health and physician's satisfaction while dealing with MDR-TB therapy [16].…”

Assessment of anxiety, depression, loneliness and stigmatization in patients with tuberculosis

“…Moreover, in a recent study patients with PT were reported to have higher depression, anxiety, loneliness, stigmatized, and social isolation levels may affect adversely proper antituberculosis treatment compliance. (4)(5)(6) Tuberculosis is known to be a social illness. In addition, tuberculosis is accepted as a stigmatizing disease as well.…”

Depression: a silent driver of the global tuberculosis epidemic

“…Depressed individuals with TB are less likely to seek care promptly, if at all, and once in treatment are significantly less likely to take medications consistently and/or completely (2,4,7). These treatment irregularities can lead to drug resistance, morbidity and mortality.…”