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

Table 4

Studies reporting patients’ psychological reactions and disease perceptions about TB.

First author/ references	Reports from studies
Eram [39]	Tuberculosis is a disease both of individual and society and patients’ first reactions to the diagnosis were tension/anxiety (30%), loss of interest/depression (26%), denial (6%), could not explain how they felt (20%), and only 18% were hopeful of cure.
Rajeswari [109]	The initial reaction of patients to the disclosure of the diagnosis was worry (50%) and suicidal thoughts (9%).
Deribew [92]	People with perceived stigma may have a low self-image and be socially isolated which may predispose them to common mental disorders.
Jaggarajamma [110]	Perceived stigma which refers to the fear of discrimination or acceptability was higher than enacted stigma, which refers to actual discrimination or acceptability.
Courtwright [111]	The most common cause of TB stigma is the risk of transmission from TB infected individuals to susceptible community members but also because of its association with HIV, poverty, low social class, malnutrition, or disreputable behavior. Also, TB stigma had a more significant impact on women and on poor or less-educated community members, which is especially concerning given that these groups are often at higher risk for health disparities [112]. TB stigma may, therefore, worsen preexisting gender- and class-based health disparities, and it is perceived to increase TB diagnostic delay and treatment nonadherence [37, 113].
Naidoo [38]	People who have a lifelong or infectious disease and who have limited social, psychological, and economic resources find it extremely difficult to maintain a reasonable quality of life and that helplessness [114] and depression have a negative influence on adherence to treatment.
Marra [115]	There are numerous aspects of active TB that may lead to a reduction in the quality of life, such as prolonged therapy with multiple, potentially toxic drugs that can lead to adverse reactions in a significant number of patients. Also, there is considerable social stigma associated with active TB leaving the individual feeling shunned and isolated from their friends and families, and there is a lack of knowledge regarding the disease process and its treatment which may contribute to feelings of helplessness and anxiety.