40 TB inpatients of the Sanatorium, in Punjab. The mean scores of TB patients were compared with the mean scores of patients suffering from (a) cardiac illness where surgery was indicated (4); (b) chest disease where surgery was indicated (4); (c) vasectomy cases (10).
(1) Maudsley Personality Inventory (modified) (2) Cornell medical Index (Health Questionnaire).
TB patients and vasectomy cases (which is of course a normal population) had lower scores on MPI tuberculosis, and vasectomy cases had lower scores on CMI.
The neurotic scores on MPI of cardiac patients awaiting surgery were the highest, followed by chest diseases of patients awaiting surgery. The “physical distress” section of CMI reveals that a patient of cardiac illness awaiting surgery scores highest followed by patients of chest Diseases. In Maudsley Personality Inventory and in Cornell Medical Index (Health Questionnaire), or less.
About 56% of the male patients had a habit of drinking. Although scores on the “neurotic dimension” of MPI of chest diseases patients and TB patients are similar, there is a significant difference in scores on the “physical distress” section of CML It may be concluded from this fact that the difference in physical distress will not have a corresponding difference in neuroticism level.
100 tuberculous patients to analyze the effect of social background factors on the psychiatric and psychological examination.
Psychiatric interview and psychological tests (MMPI, Rorschach, and Wartegg).
No correlation between the social group variable and those obtained in the psychiatric interview or the MMPI test could be demonstrated.
The purpose of the study was to analyze the effect of social background factors on the psychiatric and psychological examination. On the basis of the projective tests, subjects in the lower social classes were considered more disturbed.
50 TB patients admitted to the TB Ward of K.G.’s Medical College and Gandhi Memorial and Associated Hospitals.
Rorschach test, TAT
Lack of emotional control, insecurity, anxiety, and depressive features were observed in 60% of the cases.
31% psychiatric morbidity in patients admitted in medical wards [47] psychiatric morbidity of 20% in their study of two general medical wards [48].
No significant differences were found on Rorschach test. On Thematic Apperception Test, more females projected fear of death and fear of being cast out of the social sphere.
96 inpatient proved male cases of pulmonary tuberculosis, in Udaipur.
Self-rating depression scale of Zung
52 out of 96 patients showed evidence of depression (i.e., 54.17%).
In primary care, clinics/center have estimated a prevalence rate of depression: 21%–40.45% [50–53].
Excluded those patients who had previous history of any psychiatric illness before developing pulmonary tuberculosis and patients developing psychiatric illness other than depression. Depression was related to the duration and severity of the illness.
272 pulmonary tuberculosis patients with positive sputum, in Agra.
Psychiatric screening schedule developed on the basis of Wing’s Screening PSE/diagnostic labels according to ICD.
29.4% of psychiatric comorbidity (19.4% with a diagnosis of depression and 6.6% with anxiety).
24.4% of 258 patients to be suffering from a purely psychiatric problem (anxiety neurosis 12.8% and depression 10.1%) and an additional 12% to have an associated psychiatric disorder bringing the overall morbidity to 36%. [55] 36% psychiatric morbidity in patients seen in general practice (Outpatient departments) [56, 57].
Patients aged below 50 years, with a positive sputum.
100 tubercular patients/control group: patients undergoing treatment for long-term fever of any etiology except tuberculosis from a clinic of Tuberculosis and Chest Diseases Hospital, Allahabad.
Hamilton rating scale for depression.
32% of tuberculosis patients demonstrated the presence of depression.
7% control cases , df = 2, .
The depression was directly related to the duration of illness.
70 inpatients with TB matched to 70 inpatients with nontuberculous, bronchiectasis, from the sanatorium for chest diseases, Trivandrum.
Clinical evaluation was performed, and diagnosis was arrived at as per ICD-9.
28.87% of psychiatric comorbidity (15.7% with a diagnosis of depressive neurosis, 7% with anxiety neurosis, and 3% with alcohol dependence).
7.14% of patients with nontuberculous bronchiectasis were found to be abnormal in psychiatric terms , df = l, .
All patients had been on medication and followup for at least 6 months without any untoward reactions to ensure that the symptoms produced were not due to antituberculous medication per se/rule out CNS involvement.
150 patients of pulmonary tuberculosis admitted in Hospital for Chest Diseases and Tuberculosis, Jaipur.
Beck Depressive Inventory.
A depression rate of 49% in hospitalized tuberculous patients, which decreased with favorable response to chemotherapy but increased in those with persistently positive sputum, up to 64%.
31% of medical inpatients had psychiatric comorbidity (16% depression, 9% anxiety neurosis, and 5% organic brain syndrome) [47].
The depression was directly related to the duration of illness, severity of disease, and response to chemotherapy.
The depression was related to the duration of illness, and severity of the disease/excluded those patients who had previous history of any psychiatric illness before developing pulmonary tuberculosis and those with severe illness and on specific anti-TB meds.
Neurotic disturbances have been diagnosed in 64.7% of the patients, with asthenic and depressive syndromes constituting 84.7% of all mental disorders.
Premorbid personality peculiarities are significantly correlated with the incidence and nature of mental disorders being most frequent in individuals with asthenic and psychasthenic features. Specific antituberculosis therapy fails to control neurotic disturbances by the end of the main course of the inpatient treatment in 51.5% of the patients which poses a question about the necessity of psychotropic therapy.
100 cases of chest diseases: 50 tubercular and 50 nontubercular/ control group, admitted to a Chest Hospital, in Kanpur.
Cornell Medical Index Questionnaire.
70% in the study group were found to have psychiatric problems/ depression was prevalent in the study group (77%).
56% in the control group were found to have psychiatric problems/anxiety state was most common in the control group (57%).
The prevalence of psychiatric illness was higher in females than males, high between 15 and 44 years (91%) and more in the low socioeconomic group, illiterates, and semiliterates; more in housewives, unskilled workers, and large and joint families. Higher psychiatric morbidity was observed in chronic, far-advanced and resistant tuberculosis patients.
To examine the mental status and personality traits of 61 patients with newly diagnosed pulmonary tuberculosis of limited extent.
MMPI
Revealed the following general types of a response to the disease: alienation from the people around, depression reaction (18%), negative attitude to treatment (16.1% of the patients refused treatment and 13.1% refused surgical treatment), social adaptation impairment, neglect of the generally accepted behavior patterns, and schizoid personality traits. Along with this, the individual forms of a response to disease detection were determined. They were manifested by a number of symptom complexes: hypochondriac (13.6%), anxiety depression (18.4%), and paranoid (9.1%).
The mental status and the types of response were shown to differ from the same reactions in somatic patients with other abnormalities.
These mental disorders gravely affected the patients and made treatment of the basic disease more complicated. A long-term conservative treatment aggravated depression, hysterical, and schizoid personality traits.
100 black hospitalized tuberculosis (TB) patients in Pretoria, South Africa.
The 13-item shortened BDI and the Rosenberg Self-Esteem scale.
A depression rate of 68%
The prevalence of psychiatric disorder in primary care was 21.3%. Depressive neurosis (51.7%) and anxiety neurosis (36.3%) were the most common disorders [66].
Self-esteem scores dropped in accordance with category of depression.
121 TB patients seen in a Medical Center in New York.
22% psychiatric comorbidity.
Prevalence of major psychiatric disorders in primary health care is 11.9% in US (1995). 6.3% of patients attending primary care facilities suffer from depression [68] in acutely ill medical inpatients 27.2% prevalence of psychiatric disorders; major depressive disorder was present in 5.1% [69].
153 cases of pulmonary tuberculosis who had been defaulting in their treatment patients and 91 freshly diagnosed (to serve as controls).
Cornell Medical Index (CMI) to monitor psychiatric illness and Eysenck's Personality Inventory (EPI) for personality evaluation.
Depression followed by anxiety neurosis was the commonest of the psychiatric disorders. In EPI, the defaulters had more of neurotic personality compared with controls, while the extrovert traits were about equal.
Significantly higher proportion of defaulters had abnormal CMI scores.
The study suggested that identification of the patients at the start of treatment could help in reducing default because depression and anxiety neurosis could be treated along with tuberculosis.
53 outpatients with pulmonary tuberculosis seen in a Nigerian chest clinic compared to 20 long-stay orthopedic patients with lower limb fractures and 20 apparently healthy controls.
30-item General Health Questionnaire (GHQ-30), the Present State Examination (PSE), and a clinical evaluation based on ICD-10.
30.2% prevalence of psychiatric disorders/11.3% prevalence of depression.
15% prevalence of psychiatric disorders in the orthopedic group and 5% in healthy controls.
The types of psychiatric disorders encountered included mild depressive episode, generalized anxiety disorder, and adjustment disorder (ICD-10). Psychiatric morbidity was higher in tuberculosis patients with low educational attainment.
157 male inpatients: 42 with recently diagnosed (RDtb), 39 with defaulted (Dtb), 39 with multidrug resistant tuberculosis (MDRtb), and 38 with COPD, in Ankara, Turkey.
Composite International Diagnostic Interview (CIDI)/Brief Disability Questionnaire.
Depression and/or anxiety comorbidity was 19% for RDtb, 21.6% for Dtb, and 25.6% for MDRtb.
Depression and/or anxiety comorbidity was 47.3% for COPD.
Patients with psychiatric comorbidity had higher disability scores than the groups without psychiatric comorbidity.
52 TB patients attending a primary care centre in Vellore.
Revised Clinical Review Schedule for assessing psychiatric morbidity and the Short Explanatory Model Interview to identify patients’ perspectives of their illness.
17.3% of subjects satisfied the International Classification of Diseases 10 Primary Care Criteria for psychiatric disorders. Depression was the commonest disorder (13.5%).
Studies done in primary care clinics/center have estimated a prevalence rate of depression of 21%–40.45% [50–53]. 36% psychiatric morbidity in patients seen in general practice (Outpatient departments) [56, 57]. Prevalence of major psychiatric disorders in primary health care 22.4%, depression (9.1%) [68].
1/4 of patients defaulted during 5 months treatment while just a third completed 6 months course of therapy.
103 tuberculosis eases and a similar number of age, sex matched controls to find out the difference in illness behavior profile of the two groups.
Illness Behavior Questionnaire (IBQ).
TB patients exhibited features pertaining to general hypochondriasis, affective inhibition, and affective disturbance more than controls.
Denial of problem was seen more in controls. The differences between the two groups were statistically significant.
The tuberculosis patients were receiving treatment from two DOTS centres in East Delhi, and the controls were from the same locality. A valid illness behavioral profile of these patients to be used as an adjuvant to the implementation of the revised tuberculosis control programme.
A retrospective record review of 60 patients who had received individualized therapy for MDR-TB.
Defined using DSM-IV criteria.
Depression was the most frequent baseline finding, occurring in 38.3% of the patient population and alcoholism in 3.3%.
Side effects of medication include: depression newly diagnosed in 18.3% patients after a median of 8.5 months, anxiety in 11.7%, and psychotic symptoms in 10%.
206 patients with pulmonary tuberculosis and mental disorders from the Kirov Region compared with 154 control patients with pulmonary tuberculosis without mental disorders.
In both group, males fell ill with tuberculosis in the prime of their life, whereas females did at their old age. Males with mental disorders are more susceptible to tuberculosis than mentally healthy patients.
In contrast, females with mental disorders are much less susceptible to tuberculosis than mentally healthy patients. Women of reproductive age are the least prone to tuberculosis particularly in the presence of mental disorders.
110 adolescent patients with respiratory tuberculosis and 89 healthy adolescents aged from 13 to 17 years.
The adolescent patients differed from healthy individuals by inadequate communicability, sensitive, liability to accumulation of negative emotions, by bad need for support and feelings to be taken hard, by marked internal strain, and yearning for showing his/her individuality.
This also had led to the lower behavioral range, made social adaptation difficult, promoted the susceptibility to stress exposure, and increased a risk for a disease.
132 patients with tuberculosis and 71 healthy volunteers.
Symptom Checklist 90 (SCL-90) and Social Support Rating Scale (SSRS).
Somatization, obsessive compulsiveness, anxiety, phobic anxiety, and paranoid ideation, psychoticism and the mean of positive factors of SCL-90 of the tuberculosis group→/. The SSRS results of subjective and objective supports and total score of social supports of the tuberculosis group*
→were significantly higher than those of the control group/. *were much lower than those of the control group.
253 patients with fibrocavernous pulmonary tuberculosis and 178 patients with infiltrative pulmonary tuberculosis.
Standard multifactorial personality study and the Lusher tests, special questionnaire surveys.
Irrespective of the duration of the disease, specific psychological peculiarities, and altered behavior and attitude to themselves and others appear in both males and females, leading to the socially dangerous manifestation of behavioral aggression.
The study has developed a procedure to prevent the manifestation of aggressive behavior in patients with pulmonary tuberculosis. Goal-oriented correction prevents distresses resulting in decompensation.
152 males with fibrouscavernous pulmonary tuberculosis and 123 males with infiltrative pulmonary tuberculosis.
Multifactorial psychological personality testing.
The psychological characteristics were more impaired in male patients with chronic pulmonary tuberculosis. Life quality in male patients with chronic pulmonary tuberculosis is still worse than in those with first diagnosed pulmonary tuberculosis.
By recognizing that life quality is an integrative indicator of the functional parameters of health and the social and psychological parameters of living standards and life way: life quality in all male patients with pulmonary tuberculosis may be considered to be low.
A retrospective case series was performed among the first 75 patients to receive individualized MDR-TB therapy in Lima, Peru.
Based on DSM-IV criteria.
Baseline depression and baseline anxiety were observed in, respectively, 52.2% and 8.7% of this cohort. The incidence of depression, anxiety, and psychosis during MDR-TB treatment was 13.3%, 12.0%, and 12.0%, respectively.
A 6.7% prevalence rate of depression in the general population of Lima, Peru [82].
Baseline rates of anxiety and psychosis were comparable to those of the general population of Lima.
46% of psychiatric morbidity, majority is depressive disorders (36%) followed by anxiety disorders (24%)/comorbidity of depressive and anxiety disorders in 16% of patients.
31% psychiatric morbidity in patients admitted in medical wards [47] psychiatric morbidity of 20% in their study of two general medical wards [48].
Depressive disorders are more in lower socioeconomic groups, patients with longer duration of tuberculosis illness, who stayed in hospital for longer duration and patients receiving non-RNTCP drugs. Anxiety disorders are more in lower educated group, tuberculosis associated with complications and patients with longer hospital stay.
105 patients affected by tuberculosis seen at the chest clinic of University of Nigeria Teaching Hospital.
Zung Self-rating depression scale.
41.9% of patients had depressive symptoms.
The prevalence of psychiatric disorder in primary care was 21.3%. Depressive neurosis (51.7%) and anxiety neurosis (36.3%) were the most common disorders [66].
Being widowed or single, increasing age, unemployment, duration of illness, duration of treatment, and being accompanied to hospital increased the prevalence of depressive symptoms amongst TB patients. However, unemployment, being accompanied to hospital, and duration of treatment significantly increased prevalence of depression in affected patients.
100 patients attending tuberculosis clinic under Rural and Urban Health Training Centre in Aligarh.
Revised Clinical Review Schedule for assessing psychiatric morbidity and the Short Explanatory Model Interview to identify patients’ perspectives of their illness.
30% had anxiety or tension while 26% had loss of interest for life or depression. 6% of patient denied the diagnosis while 20% of them could not explain how they felt.
Prevalence of major psychiatric disorders in primary health care: 22.4%, depression (9.1%) [68].
The negative reaction like tension and depression were more common in less educated patients. Similarly, this negative reaction was also more prevalent in low socioeconomic class compare to educated and higher socioeconomic class.
A retrospective cohort study with 207 participants enrolled in the DOTS treatment programme was included in the analysis of MDR acquisition.
8.8% of the patients in the cohort defaulted on therapy and 15.6% took fewer than 80% of their observed prescribed doses. 6.3% acquired MDR during the study period.
Substance abuse was identified as the only factor that was strongly associated with nonadherence with odds ratios for baseline alcohol dependence—4.38 (95% CI: 1.58–12.60); reported alcohol use in a patient during therapy—6.35 (95% CI: 2.27–17.75); and intravenous drug use—16.64 (95% CI: 3.24–85.56). The adjusted odds ratio of nonadherence for those with any kind of substance abuse was 7.30 (95% CI: 2.89–18.46). Substance abuse was also strongly associated with default, with an odds ratio of 15.57 (95% CI: 3.46–70.07) among those with baseline alcoholism and 5.14 (95% CI: 0.87–30.25) for those with reported alcohol use. Patients with any form of substance abuse had an adjusted odds ratio for default of 11.20 (95% CI: 2.55–49.17).
In TB patients, mean anxiety was 40.67, .19, and mean depression was 9.93, .71.
In COPD, mean anxiety was 45.87 and mean depression was 15.48. In BA, mean anxiety was 43.67 and mean depression was 14.31. 28.1% of patients hospitalized in general medical or surgical hospital wards had depression [74, 87].
Patients with COPD had the higher depression scores, followed by patients with BA, whereas patients with TB had the lowest depression scores. Anxiety was higher in patients with COPD compared to patients with TB.
108 consecutive outpatients with tuberculosis attending the TB clinic at the chest disease department in a Medical Centre in Karachi, Pakistan.
Hospital Anxiety and Depression scale (HADS) and the Illness Perception Questionnaire (IPQ).
46.3% were depressed, and 47.2% had anxiety.
Mean prevalence of anxiety and depression in Pakistan found to be around 34% (range 29–66% for women and 10–33% for men) in community based population.
Depression and lack of perceived control over illness in those suffering from tuberculosis are reported to be independent predictors of poor adherence.
61% of respondents had clinically significant depression presented as follows, 22.6% had mild depression, 25.2% had moderate depression, and 13.2% had severe depression.
The prevalence of psychiatric disorder in primary care was 21.3%. Depressive neurosis (51.7%) and anxiety neurosis (36.3%) were the most common disorders [66].
65 patients with TB attending the DOTS outpatient clinic in a university teaching hospital in Nigeria.
Nine-item Patient Health Questionnaire (PHQ-9).
27.7% of patients had depression.
The prevalence of psychiatric disorder in primary care was 21.3%. Depressive neurosis (51.7%) and anxiety neurosis (36.3%) were the most common disorders [66].
214 outpatients registered at DOTS centre in Kanpur, India.
Cornell Medical Index and 16PF-Test FORM-A.
82.2% had psychiatric comorbidity; 85.2% had anxiety neurosis, and 14.8% had depression. On personality assessment, 54.1% were anxious, 26% introverts, 15.8% extroverts, and 4.1% had other personality traits.
Prevalence of major psychiatric disorders in primary health care 22.4%, depression (9.1%) [68].
Patients with neurotic trait defaulted more as compared to other personality traits. On multivariate analysis, smoking habit and alcoholism were strongly associated with default whereas age, sex, socioeconomic class, and literacy were not.
65 newly diagnosed Pulmonary TB outpatients at the District TB Control Office and TB Centre in Haripur.
Hospital Anxiety and Depression Scale (HADS).
72% of TB patients had severe/moderate level of anxiety and depression.
Prevalence of major psychiatric disorders in primary health care 22.4%, depression (9.1%) [68].
22% of TB patients with comorbid anxiety and depression showed multidrug resistance (MDR-TB). 50,7% adhered to the treatment after consulting a psychiatrist.
61 patients at three clinics in London, at diagnosis, and 2 months into therapy.
Generic health related quality of life (Short Form 36 [SF-36] and EQ-5D) and psychological burden (State-Trait Anxiety Short-Form, Center for Epidemiologic Studies Depression Scale, worry items).
Respondents’ mean anxiety and depression scores were high at diagnosis (84.2% and 38.6%, resp.), and anxiety scores remained high at followup.
24.8% prevalence of psychiatric disorders and depressive disorder was present in 16.9%, in primary care in London [69]. At diagnosis, scores for all eight SF-36 dimensions were significantly worse than UK general population norm.
Although treatment significantly improved patients’ health status within 2 months, scores for many domains remain below UK norm scores.
A cross-sectional study in three hospitals in Oromiya regional state of Ethiopia with 155 TB/HIV coinfected and 465 noncoinfected HIV outpatients.
Kessler 10 scale.
Common mental disorders (CMD) was present in 63.7% of the TB/HIV coinfected patients and in 46.7% of the noncoinfected patients.
Common mental disorders account for 9.8% of the global burden of diseases in low and middle income countries (LAMIC). 1/3 of all patients seen in primary care facilities in LAMIC present with CMDs [93].
Individuals who had no source of income, day laborers and patients who perceived stigma and rate their general health as “poor” were more likely to have CMDs.
166 with TB (36.7% were also HIV positive) who were attending a public health clinic in the Cape Metropole area of South Africa.
BDI, Social Network Support Questionnaire, a semistructured questionnaire designed to assess helplessness.
64.3% of patients had depression (mild mood disturbance—26.1%, borderline clinical disturbance—10.3%, moderate depression—15.8%, severe depression—9.7%, and extreme depression—3.6%).
10.9% of the group in the study had feelings of helplessness and inadequate social support.
A cross-sectional study with 60 TB patients admitted in the Department of Chest Medicine TB Hospital in Faisalabad, Pakistan.
Beck depressive inventory.
Depression was present in 80% of TB patients (86% in males and 71% in females).
Mean prevalence of anxiety and depression in Pakistan found to be around 34% (range 29.66% for women and 10.33% for men) in community based population.
Main causes of depression among the male TB patients were altered social relationship and among female patients TB stigma. Depression had adverse effect on drug compliance and TB treatment.
600 patients of pulmonary TB admitted in Hospital for Chest Diseases and Tuberculosis, Jaipur.
Beck depressive inventory.
Depression was present in 82% in female tuberculous inpatients and in 52.6% in males immediately after the diagnosis.
The depression was related to the duration, severity of illness, and response to chemotherapy, meaning that rate of depression decreased to 72.5% in those who responded favorably to chemotherapy, but in failures of treatment depression further increases and rises to 86%.
60 patients treated for tuberculosis in Pulmonary Hospital or Sanatorium Savadisla, Romania.
Beck Depression Inventory—BDI, State Trait Anxiety Inventory STAI, and Illness Perception Questionnaire—IPQ.
6.78% for severe depression, 32.2% for moderate depression, and 32.2% for severe and 40.68% for moderate anxiety.
For patients at first admission in hospital (new case), the anxiety score is less than for chronic patients or with multiple admissions. Depression was positively correlated with anxiety.
50 TB outpatients in followup or new from a Hospital in Patna.
MINI international neuropsychiatric interview.
Common mental disorders in 76% of patients (39.47% depression, 42.1% GAD, and 13.15% organic brain syndrome/52.63% with suicidal ideation)
24%–36% rates of depression in patients admitted in medical wards for general medical conditions
Moffic HS, Paykel ES (1975) and Cavanaugh (1983) [96].
Excluded were patients with previous psychiatric or drug history.
88 TB outpatients and 81 family members visiting the DOTS Centre at University College Hospital Ibadan Centre in Nigeria.
Hamilton Depression Scale.
The prevalence of depression was 45.5% among patients.
Prevalence of depression was 13.4% among family members.
Depression was more prevalent among patients that were elderly (), with extensive disease (), of long duration (), those with category 2 tuberculosis (), those from a nuclear family (), and patients that were unmarried ().
A descriptive Study with 500 pulmonary tuberculosis patients undergoing DOTS therapy in selected areas of district Jalandhar, Punjab.
Structured checklist to measure psychological and sociological problems of pulmonary TB undergoing DOTS therapy. It consists of 20 items to which respondents were expected to answer yes/no (any other specific answer).
Among psychological problems pulmonary tuberculosis patients undergoing DOTS therapy showed maximum results in category of sadness due to disease (76.2%), followed by feeling emotionally disturbed (73.2%), followed by patients loosing temper while dealing with others (53.2%), and in the presence of sleep disturbance (51.2%).
Among sociological problems, patients with pulmonary tuberculosis undergoing DOTS therapy showed maximum results in category of finding difficulty to continue job (41.2%), followed by preferring stay alone (39.6%), followed by not finding cooperation from colleagues at work place (25.2%), followed by feeling of isolation by friends and relatives (24.8%), and loss of job due to disease (23.6%).
A cross-sectional survey of 4900 tuberculosis public primary care patients within one month of initiation of antituberculosis treatment.
Kessler-10 item scale 10-item Alcohol Disorder Identification Test (AUDIT).
Overall prevalence of psychological distress in this study was 32.9% (K-10 ≥ 28) and 81.1% (K-10 ≥ 16), respectively. The authors in this study recommend the use of a cutoff score of 16 for use in South Africa, particularly, within the public sector health clinics in order for cost-efficient treatment programmes to be implemented on a large scale. 23.3% were hazardous or harmful alcohol users 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking) as defined by the AUDIT.
The prevalence of psychological distress in this study is inline with the prevalence rates of depression or common mental disorders in most other studies with tuberculosis patients. 46%−80% in LMICs rates of hazardous or harmful alcohol use. In general, public primary care patients in South Africa 13.3% and 19.2% and in a national population-based survey in South Africa (9%) [93].
46.3% perceived their health status as fair or poor. Adherence to TB medication, 33.9% indicated that they had missed at least 10% their medication in the last 3-4 weeks. In this study, there was no association found between TB and HIV treatment nonadherence and common mental disorders as found in other studies. Alcohol use disorders in tuberculosis patients in low and middle income countries: Russia: 24–62% alcohol abuse/dependent, India: 14.9–32% alcohol abusers/alcoholics, Brazil: 14–24% alcohol abusers, South Africa: 31–62% alcohol misuse.
4900 public primary care adult patients (either new or retreatment cases) from clinics in high TB burden districts from three provinces in South Africa.
Brief screening self-report tools were used to measure PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse.
The prevalence of PTSD symptoms was 29.6%.
Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB–HIV coinfected, and the number of other chronic conditions.
