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.

Background: Few studies have examined the relation between alexithymia (i.e. the inability to recognize and verbalize emotions) and professional burnout. Considering the absence of relevant studies in the Greek scientific literature, the aim of this work was to examine the associations of alexithymia with the three facets of professional burnout, the perception of family support and depression in nursing personnel.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities.

BackgroundDepression necessitating assistance from health professionals has a lifetime prevalence of 10%. Chronic disease increases comorbidity with mood and/or anxiety disorders. Patients with chronic pulmonary disease present with severely impaired functionality, chronic somatic and psychogenic pain, require frequent hospitalizations and have a dependency upon medical and nursing personnel. In the present study we assessed anxiety and depression in patients hospitalized for pulmonary disease in a pulmonary disease hospital.MethodsWe assessed anxiety, using the Spielberger state-trait anxiety scale, and depression, using the Beck Depression Inventory, in 132 patients with pulmonary disease.ResultsA total of 49.2% of the sample had moderate or severe depression and 26.5% had anxiety. Women had higher depression and anxiety scores than men (t test, p < 0.05). Depression was positively correlated with anxiety, age and time from diagnosis. Anxiety was positively correlated with depression and time from diagnosis (Pearson r = 0.62 and 0.29, p < 0.01). Patients with chronic obstructive pulmonary disease and bronchial asthma had higher depression scores than patients with tuberculosis (t test, p < 0.01).ConclusionDepression and anxiety are very prevalent in patients with pulmonary disease, especially chronic disease. This may be a very important negative factor in patients' adaptation to the chronic course of their disease.

We assessed the relationships between burn out, depression and sense of coherence (SOC) using the Maslach Burnout Inventory, Beck's depression inventory and Antonovsky's SOC questionnaire in a large sample of 17 male and 62 female Greek nurses. Analysis showed that SOC in nursing staff was correlated with burnout (BO) and depression, while the latter was correlated to a lesser degree with BO. The relationship of BO with depression seems to be the result of the relationship between depression and SOC. Thus, we could hypothesize that the degree of SOC renders persons either vulnerable or resistant to both depression and BO, though further studies are warranted. In the hospital setting, the intervention by specialized personnel in order to assist nursing staff with BO may be an appealing option. Further, prevention programs aimed at helping individuals prone to BO could also be envisaged.