A Survey of Anxiety and Depressive Symptoms in Pulmonary Tuberculosis Patients With and Without Tracheobronchial Tuberculosis

Abstract

Background and Objective: Anxiety/depression and tuberculosis are global public health problems. The incidence of psychiatric morbidities is high among tuberculosis patients. However, little is known about the prevalence of anxiety and depression among Chinese pulmonary tuberculosis (PTB) patients, especially those with tracheobronchial tuberculosis (TBTB). The goal of the present study was to explore the prevalence of and associated factors of anxiety and depressive symptoms among PTB patients with and without TBTB.Methods: A cross-sectional survey of PTB patients from three hospitals in Liaoning, China, was conducted using a structured questionnaire. Depression and anxiety were evaluated by using the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire-9 (PHQ-9).Results: According to HADS and PHQ-9, 17.73 and 18.13% of 1252 PTB patients, respectively, had significant depressive symptoms and based on HADS scale, 18.37% had significant anxiety symptoms. Approximately 70% of patients with probable depression also had significant anxiety symptoms, and vice versa, and 69.6% patients with anxiety symptoms were also diagnosed with probable depression in our study population. Dyspnea and TBTB were significantly associated with depressive symptoms. Other depressive symptoms-related factors included age, divorce, abnormal body mass index (BMI), and low income. Patients with lower incomes, symptoms of dyspnea, or a combination of ≥3 clinical symptoms had an increased risk of anxiety symptoms, while patients with occasional or frequent alcohol consumption had a reduced risk of anxiety symptoms.Conclusion: Depressive and anxiety symptoms are common among PTB patients, especially those with TBTB. Screening for depression and anxiety is essential for identifying patients who require further psychosocial assessment and support.

The association of household food insecurity and HIV infection with common mental disorders among newly diagnosed tuberculosis patients in Botswana

“…Approximately 26 % of enrolled TB patients had PHQ-9 scores indicative of moderate to severe depression and 15 % indicative of suicidal ideation. Our estimate was comparable to recent studies in several countries that examined depression (moderate to severe) among TB patients, including Ethiopia (17•6-54•0 %) (32)(33)(34) , South Africa (32•9 %) (13) , Angola (49•4 %) (35) and China (18•1 %) (36) . They were, however, considerably lower than those found in Ethiopia using PHQ-9 by Ambaw et al (32) ; these differences may have arisen from variations in study location and population.…”

“…Approximately 46 % of our participants reported anxiety symptoms, comparable with published estimates of other settings: Ethiopia (41•5 %) (34) , Angola (38•3 %) (35) and China (18•4 %) (36) . None of those studies utilised the ZUNG scale; instead, Generalized Anxiety Disorder Questionnaire and Hospital Anxiety and Depression Scale were used to assess the presence of anxiety symptoms, which might be an explanation for the discrepant results.…”

The prevalence of depression among patients with tuberculosis: a systematic review and meta-analysis

“…The characteristics of the study populations included in this study are depicted in Table 1. Out of 25 studies included in the review, seven were from Pakistan [15,[26][27][28][29][30][31], seven from India [32][33][34][35][36][37][38], three from Nigeria [18,39,40], four from Ethiopia [11,19,41,42], one from Brazil [43], one from China [44], one from Cameron [45], and one from Turkey [47]. The studies included in this review were published between 2006 and 2019, with the sample size ranging between 45 participants in India and 1252 participants in China.…”

The interplay between depression and tuberculosis

“…Such risk factors include marital status, namely divorce; dyspnea and other clinical symptoms of pulmonary tuberculosis (PTB) or other chronic respiratory diseases; social pressures or stigma following a diagnosis of TB among young individuals; low income; and smoking history . Interestingly, it is unclear whether or not alcohol consumption is a risk factor for depression in TB . However, no risk factors specific to TB that are associated with comorbid depression have been identified in patients with TB .…”

“…17,30 Interestingly, it is unclear whether or not alcohol consumption is a risk factor for depression in TB. 31,32 However, no risk factors specific to TB that are associated with comorbid depression have been identified in patients with TB. 19,33 A prospective controlled trial in India found that psychological intervention significantly improved compliance of anti-TB treatment.…”