Prevalence of Depression Among Newly Diagnosed MDR Tuberculosis Patients at the Time of Registration- An Experience From Dots Plus Centre

Abstract

BACKGROUND MDR tuberculosis remains a leading chronic infection of lung and responsible for significant morbidity and mortality throughout the world and in India also. Depression is also a disorder of major public health importance in terms of its prevalence and the suffering, dysfunction, morbidity and economic burden. Depression and MDR tuberculosis co-exists, because of physical changes from the illness trigger the depression resulting in vicious cycle. So, it is very important to establish the prevalence of depression in MDR tuberculosis. To the best of our knowledge, very little is known about depression in MDR tuberculosis patients.The objective of this study is to find out the prevalence of depression among newly diagnosed MDR tuberculosis patients before the start of Category-IV treatments. MATERIALS AND METHODSThis was a cross-sectional study conducted in Department of Respiratory Diseases, GMC, Kannauj (India). A total of 130 MDR-TB patients were included in the study, which were enrolled for treatment in this unit from January 2017 till June 2017 and assessed at the time of registration for depression. Hamilton depression rating scale (HAM-D) was used to assess depression among MDR-TB patients. RESULTSOne hundred and thirty patients with MDR tuberculosis were enrolled during the study period. There were 93 males (71.5%) and 37 (28.4%) females. The mean age of study subject was 29.45 ± 14.49 years with a male-to-female ratio of 2.5: 1. Depression was not found in 6 (4.62%) patients, whereas 124 (95.3%) of the study participants were classified as depressive on the HAM-D scale. 65 patients (50%) had mild depression, 26 patients (20%) had moderate depression and 33 patients (25.3%) were diagnosed with severe depression. CONCLUSIONDepression is a very important negative factor to treatment adherence and it is important to diagnose and treat depression in time to get the desired results of TB treatment. Multi-drug resistant TB (MDR-TB) is defined as M. tuberculosis resistant to isoniazid and rifampicin with or without resistance to other drugs. Data from studies 'Financial or Other Competing Interest': None. Submission 14-11-2017, Peer Review 07-01-2018, Acceptance 12-01-2018, Published 22-01-2018. Corresponding Author: Dr. Vipul Singh, Associate Professor, Department of Psychiatry, Government Medical College, Kannauj, U. P. E-mail: drvipulsingh@yahoo.co.in DOI: 10.14260/jemds/2018 conducted by NIRT (erstwhile TRC) and NTI, have found MDR-TB levels of 1% to 3% in new cases and around 12% in re-treatment cases. 2-3 RNTCP has recently undertaken three community-based state level drug resistance surveillance (DRS) studies in Gujarat, Maharashtra and Andhra Pradesh. These surveys have been conducted as per a common generic protocol based on internationally accepted methodology and have estimated the prevalence of MDR-TB to be about 3% in new cases and 12% -17% in re-treatment cases. 4 Common mental disorders (CMDs) including depression, anxiety disorders and substance use disorders are a huge...