https://doi.org/10.4081/monaldi.2021.1704

Depression and anxiety symptoms among people with rifampicin-resistant tuberculosis receiving in-patient care in the National Pulmonology Reference Institute in Romania

Vol. 91 No. 1 (2021)
Published: January 14, 2021
Tuberculosis, drug-resistance, HADS, depression, anxiety
Abstract Views: 1170
PDF: 642
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Alexandru Stoichita
dr.alexandru.stoichita@gmail.com
National Institute of Pneumophtisiology “Marius Nasta”, Bucharest, Romania.
Andreea Dumitrescu
National Institute of Pneumophtisiology “Marius Nasta”, Bucharest, Romania.
Ana Ciobanu
World Health Organization, Regional Office for Europe, Copenhagen, Denmark.
Cristian Oancea
https://orcid.org/0000-0003-2083-0581
University of Medicine and Pharmacy” Victor Babes”, Timisoara, Romania.
Fildan Petronela
Faculty of Medicine “Ovidius”, University of Constanta, Romania.
Radu Dabja
University of Medicine and Pharmacy” Prof. Dr. Grigore T. Popa”, Iasi, Romania.
Kostyantyn Dumchev
https://orcid.org/0000-0003-2862-4977
Ukrainian Institute on Public Health, Kyiv, Ukraine.
Andrei Dadu
World Health Organization, Regional Office for Europe, Copenhagen, Denmark.
Beatrice Mahler-Boca
National Institute of Pneumophtisiology “Marius Nasta”, Bucharest, Romania.
Kristina Akopyan
https://orcid.org/0000-0003-0177-1870
Tuberculosis Research and Prevention Center NGO, Yerevan, Armenia.

Mental health comorbidities are common among tuberculosis patients, with higher prevalence among people with rifampicin-resistant/multidrug-resistant (RR/MDR) tuberculosis.  TB and depression share common risk factors adding to the overall disease burden. There is limited evidence about prevalence of depression and anxiety symptoms among tuberculosis patients in Romania. We assessed the prevalence of depression and anxiety symptoms and their evolution over the course of the treatment in RR/MDR-TB patients receiving in-patient care at the National Institute of Pneumonology (NIP) “Marius Nasta†in Romania during May-September 2020. We conducted a cohort study and used the Hospital Anxiety and Depression Scale (HADS) to assess the prevalence of depression and anxiety (defined as score≥ 8) symptoms at admission (baseline) and the second month of in-patient treatment (follow-up). Difference between baseline and follow-up depression and anxiety symptoms were assessed using McNemar test. Binary logistic regression was used to evaluate the association between sociodemographic and clinical characteristics with the presence of depression and anxiety symptoms at baseline. The cohort included 46 patients, 63% were male, mean age was 46 (±13.3) years. The prevalence of depression and anxiety in our cohort was 46% and 43% at baseline respectively, and 50% and 39%, at the follow-up respectively. About one third (7/25) of patients who had normal HADS depression score at baseline, had an increase above the threshold at the second month of treatment. No statistical difference in prevalence of depression or anxiety was found between the baseline and second month of treatment. Unadjusted analysis showed that odds of depression at baseline was lower in patients with education above 8th grade compared to patients with education below 8th grade (odds ratio=0.2, 95% confidence interval: 0.1,0.8, p=0.026). The study revealed high prevalence of depression and anxiety among RR/MDR-TB patients admitted to the NIP, underlining the necessity of evaluating the mental health of TB patients and linking them to appropriate care.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
WHO. Global tuberculosis report 2019. Geneva: World Health Organization; 2019. Available from: http://www.who.int/tb/publications/global_report/en/
WHO. Tuberculosis surveillance and monitoring in Europe 2019: 2017 data. Accessed on: 2019 Nov 22. Available from: https://apps.who.int/iris/handle/10665/311349
Dadu A, Hovhannesyan A, Ahmedov S, et al. Drug-resistant tuberculosis in eastern Europe and central Asia: a time-series analysis of routine surveillance data. Lancet Infect Dis 2020;20:250–8.
WHO. Romania Tuberculosis Profile. 2018 Accessed on: 2019 Nov 21. Available from: https://www.who.int/data/gho/data/countries/country-details/GHO/romania?countryProfileId=d97baa4c-59b0-44e3-998b-c82831e04ea6
Romania’s Ministry of Health. National Strategy of TB control in Romania 2015-2020.
Migliori GB, Tiberi S, Zumla A, et al. MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network. Int J Infect Dis 2020;92:S15-25.
WHO. Use of high burden country lists for TB by WHO in the post-2015 era meeting of WHO’s Strategic and Technical Advisory Group for TB (STAG-TB). 2015. Available from: https://www.who.int/tb/publications/global_report/high_tb_burdencountrylists2016-2020.pdf
WHO. Depression and other common mental disorders. Global health estimates. 2017. Available from: https://www.who.int/mental_health/management/depression/prevalence_global_health_estimates/en/
Ige OM, Lasebikan VO. Prevalence of depression in tuberculosis patients in comparison with non-tuberculosis family contacts visiting the DOTS clinic in a Nigerian tertiary care hospital and its correlation with disease pattern. Ment Health Fam Med 2011;8:235-41.
Peltzer K, Naidoo P, Matseke G, et al. Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa. BMC Psychiatry 2012;12:89.
Husain MO, Dearman SP, Chaudhry IB, et al. The relationship between anxiety, depression and illness perception in tuberculosis patients in Pakistan. Clin Pract Epidemiol Ment Health 2008;4:4.
Duko B, Gebeyehu A, Ayano G. Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, Cross sectional study. BMC Psychiatry 2015;15:214.
Truzyan N, Petrosyan V, Harutyunyan A, et al. Depressive symptoms among TB patients in Armenia. Eur J Public Health 2015;25:ckv176.166.
Moussas G, Tselebis A, Karkanias A, et al. A comparative study of anxiety and depression in patients with bronchial asthma, chronic obstructive pulmonary disease and tuberculosis in a general hospital of chest diseases. Ann Gen Psychiatry 2008;7:7.
Man MA, Bondor C, Dantes E, et al. Depressive syndrome, anxiety and illness perception in tuberculosis patients. Available from: http://www.wseas.us/e-library/conferences/2011/Cambridge/MEDICAL/MEDICAL-28.pdf
Aydin IO, Uluşahin A. Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: applicability of GHQ-12. Gen Hosp Psychiatry 2001;23:77–83.
Iovan I, Vancea D, Fratila Z, Burlacu O. Anxiety and depression in tuberculosis hospitalized patients in comparison to healthy individuals. Eur Respir J 2012;40:P2591.
Duko B, Bedaso A, Ayano G. The prevalence of depression among patients with tuberculosis: A systematic review and meta-analysis. Ann Gen Psychiatry 2020;19:30.
Sweetland AC, Kritski A, Oquendo MA, et al. Addressing the tuberculosis-depression syndemic to end the tuberculosis epidemic. Int J Tuberc Lung Dis 2017;21:852–61.
Shen TC, Wang CY, Lin CL, et al. People with tuberculosis are associated with a subsequent risk of depression. Eur J Intern Med 2014;25:936–40.
Natani GD, Jain NK, Sharma TN, et al. Depression in TB patients: correlation with duration of disease and response to anti-tuberculous chemotherapy. Indian J Tubercul 1985;32:195.
Balaji AL, Abhishekh HA, Kumar NC, Mehta RM. Depression in patients with pulmonary tuberculosis in a tertiary care general hospital. Asian J Psychiatry 2013;6:251-2.
Aamir S, Aisha. Co-morbid anxiety and depression among pulmonary tuberculosis patients. J Coll Physicians Surg Pakistan 2010;20:703-4.
Thomas BE, Shanmugam P, Malaisamy M, et al. Psycho-socio-economic issues challenging multidrug resistant tuberculosis patients: A systematic review. PloS One 2016;11:e0147397.
McQuistion HL, Colson P, Yankowitz R, Susser E. Tuberculosis infection among people with severe mental illness. Psychiatr Serv 1997;48:833–5.
Lopez AG. Tuberculosis and the severely mentally ill. Am J Psychiatry 1994;151:151-2.
Chandra M, Rana P, Chandra K, Arora VK. Tuberculosis - Depression syndemic: A public health challenge. Indian J Tuberc 2019;66:197-202.
Bakhla A, Gore P, Srivastava S. Cycloserine induced mania. Indian Psychiatry J 2013;22:69.
Saraf G, Akshata JS, Kuruthukulangara S, et al. Cycloserine induced delirium during treatment of multi-drug resistant tuberculosis (MDR-TB). Egypt J Chest Dis Tuberc 2015;64:449–51.
Das D, Singh H. Cycloserine induced depression in a case of multidrug resistant tuberculosis. World J Pharm Phamaceutical Sci 2017;6:1069–73.
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: An updated literature review. J Psychosom Res 2002;52:69–77.
Herrmann C. International experiences with the hospital anxiety and depression scale - A review of validation data and clinical results. J Psychosom Res 1997;42:17-41.
Snaith RP. The hospital anxiety and depression scale. Health Qual Life Outcomes 2003;1:29.
Chandra N, Sheth S, Mehta R. Socio-demographic, psychosocial factors in MDR and XDR-Tb with psychiatric co morbidities and their relation with drug adherence. IOSR J Dent Med Sci 2017;16:5-8.
Wang XB, Li XL, Zhang Q, et al. A survey of anxiety and depressive symptoms in pulmonary tuberculosis patients with and without tracheobronchial tuberculosis. Front Psychiatry 2018;9:308.
Visca D, Tiberi S, Pontali E, et al. Tuberculosis in the time of COVID-19: quality of life and digital innovation. Eur Respir J 2020;56:2001998.
National Institute for Health and Care Excellence (NICE) [Internet]. Common mental health problems: identification and pathways to care. Clinical guideline. 2011. Accessed on: 2019 Nov 22. Available from: https://www.nice.org.uk/guidance/cg123
Visca D, Zampogna E, Sotgiu G, et al. Pulmonary rehabilitation is effective in patients with tuberculosis pulmonary sequelae. Eur Respir J 2019;53:1802184.
Kristina Akopyan, Tuberculosis Research and Prevention Center NGO, Yerevan

Center for Infectious Diseases, Yerevan, Armenia

How to Cite

Stoichita, Alexandru, Andreea Dumitrescu, Ana Ciobanu, Cristian Oancea, Fildan Petronela, Radu Dabja, Kostyantyn Dumchev, Andrei Dadu, Beatrice Mahler-Boca, and Kristina Akopyan. 2021. “Depression and Anxiety Symptoms Among People With Rifampicin-Resistant Tuberculosis Receiving in-Patient Care in the National Pulmonology Reference Institute in Romania”. Monaldi Archives for Chest Disease 91 (1). https://doi.org/10.4081/monaldi.2021.1704.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.