Psychological morbidity and quality of life of patients with pulmonary tuberculosis

Submitted: August 3, 2024
Accepted: September 9, 2024
Published: October 16, 2024
Abstract Views: 190
PDF_EARLY VIEW: 63
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

Tuberculosis (TB) is associated with psychological distress, poor coping, deterioration in health-related quality of life (HRQL), and stigma. However, these issues have never received sufficient attention as a part of routine care. The healthcare workers and physicians of primary contact are not sensitized to use discrete screening questionnaires to identify and address these issues. A longitudinal study was hence conducted in the Department of Pulmonary Medicine in collaboration with the Department of Psychiatry. 75 microbiologically confirmed ‘new’ pulmonary TB patients were enrolled. Socio-demographic and clinical details were noted. The patients were then evaluated for psychological distress using the General Health Questionnaire-12-Hindi version (GHQ-12) and Patient Distress Thermometer (PDT); coping strategies using the Coping Strategy Check List-Hindi Version (CSCL); HRQL using the World Health Organization Quality of Life-Brief-Hindi version (WHOQOL-Bref), and stigma using the Explanatory Model Interview Catalogue-affected persons Stigma Scale (EMIC-SS), at the start of treatment. Those having a GHQ-12 score ≥3 were labeled as ‘screen positive’ for psychological distress and referred to a consultant psychiatrist for detailed psychological assessment. Treatment was given by the psychiatrist if diagnosed with a psychiatric illness. All those without the diagnosis of a psychiatric illness were counseled by a pulmonologist. All patients were called for a follow-up visit and repeat assessments on the 15th day at the end of the intensive phase, using the same instruments employed at baseline. The patients already on treatment by the psychiatrist were again evaluated for their psychiatric illness. 32 (42.7%) patients had psychological distress (GHQ-12≥3) at baseline. 20 of them (26.7%) were diagnosed with a psychiatric illness. However, only 2 (2.7%) patients had psychological distress and psychiatric illness at follow-up (p<0.001). Mean scores of GHQ-12, PDT, CSCL, WHOQOL-Bref-26, and EMIC-SS at baseline were 3.000±1.9590, 2.333±1.2980, 3.480±2.2017, 311.63±30.201 and 5.267±1.8478, respectively. All the scores improved significantly at follow-up (p<0.001). The scores of the various instruments used in the study significantly correlated with each other. Comprehensive screening for psychological distress and assessment of HRQL should be part of routine TB care. The healthcare workers under the program should be sensitized to use the various screening tools on a day-to-day basis to identify patients who require expert psychiatrist care. The majority of the patients with distress, but without a psychiatric illness, can be handled well with dedicated counseling sessions by the healthcare workers themselves. The ancillary staff should be encouraged and trained to meet the demands in resource-constrained settings. A multidisciplinary approach, with close integration of TB programs with mental health services, is urgently required to eliminate TB.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Chen X, Du L, Wu R, et al. Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study. BMC Public Health 2021;21:6. DOI: https://doi.org/10.1186/s12889-020-10055-2
Ashaba C, Musoke D, Wafula ST, Konde-Lule J. Stigma among tuberculosis patients and associated factors in urban slum populations in Uganda. Afr Health Sci 2021;21:1640-50. DOI: https://doi.org/10.4314/ahs.v21i4.18
Agarwal N, Sarthi P. The necessity of psychological interventions to improve compliance with Tuberculosis treatment and reduce psychological distress. J Family Med Prim Care 2020;9:4174-80. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1404_20
Duko B, Dana LM, Ayano G. Psychological distress among TB patients in sub-Saharan Africa. Int J Tuberc Lung Dis 2020;24:1200-4. DOI: https://doi.org/10.5588/ijtld.20.0158
Febi AR, Manu MK, Mohapatra AK, et al. Psychological stress and health-related quality of life among tuberculosis patients: a prospective cohort study. ERJ Open Res 2021;7:00251-2021. DOI: https://doi.org/10.1183/23120541.00251-2021
Roy N, Krishnamoorthy Y, Rajaa S, et al. Health-related quality of life and its effect on TB treatment outcomes. Int J Tuberc Lung Dis 2021;25:318-20. DOI: https://doi.org/10.5588/ijtld.20.0722
Mattoo SK, Handa S, Kaur I, et al. Psychiatric morbidity in vitiligo: prevalence and correlates in India. J Eur Acad Dermatol Venereol 2002;16:573-8. DOI: https://doi.org/10.1046/j.1468-3083.2002.00590.x
Rajpoot A, Garg K, Saini V, Gupta N. Psychological morbidity in interstitial lung disease: a study from India. Monaldi Arch Chest Dis 2020;90:1434. DOI: https://doi.org/10.4081/monaldi.2020.1434
Sharma Y, Mattoo SK, Kulhara P, et al. Stress and coping in women with cervical and breast cancer in India. German J Psychiatry 2003;6:40-8.
Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med 1998;28:551-8. DOI: https://doi.org/10.1017/S0033291798006667
Frota da Rocha Morgado F, Kopp Xavier da Silveira EM, Pinheiro Rodrigues do Nascimento L, et al. Psychometric assessment of the EMIC Stigma Scale for Brazilians affected by leprosy. PLoS One 2020;15:e0239186. DOI: https://doi.org/10.1371/journal.pone.0239186
Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep 2010;125:34-42. DOI: https://doi.org/10.1177/00333549101250S407
Rouf A, Masoodi MA, Dar MM, et al. Depression among Tuberculosis patients and its association with treatment outcomes in district Srinagar. J Clin Tuberc Other Mycobact Dis 2021;25:100281. DOI: https://doi.org/10.1016/j.jctube.2021.100281
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. DOI: https://doi.org/10.1186/1471-244X-12-89
Chen X, Wu R, Xu J, et al. Prevalence and associated factors of psychological distress in tuberculosis patients in Northeast China: a cross-sectional study. BMC Infect Dis 2021;21:563. DOI: https://doi.org/10.1186/s12879-021-06284-4
Tola HH, Shojaeizadeh D, Garmaroudi G, et al. Psychological distress and its effect on tuberculosis treatment outcomes in Ethiopia. Glob Health Action 2015;8:29019. DOI: https://doi.org/10.3402/gha.v8.29019
Chen X, Xu J, Chen Y, et al. The relationship among social support, experienced stigma, psychological distress, and quality of life among tuberculosis patients in China. Sci Rep 2021;11:24236. DOI: https://doi.org/10.1038/s41598-021-03811-w
Peddireddy V. Quality of life, psychological interventions and treatment outcome in tuberculosis patients: the Indian scenario. Front Psychol 2016;7:1664. DOI: https://doi.org/10.3389/fpsyg.2016.01664
Ayana TM, Roba KT, Mabalhin MO. Prevalence of psychological distress and associated factors among adult tuberculosis patients attending public health institutions in Dire Dawa and Harar cities, Eastern Ethiopia. BMC Public Health 2019;19:1392. DOI: https://doi.org/10.1186/s12889-019-7684-2
Ayé R, Wyss K, Abdualimova H, Saidaliev S. Factors determining household expenditure for tuberculosis and coping strategies in Tajikistan. Trop Med Int Health 2011;16:307-13. DOI: https://doi.org/10.1111/j.1365-3156.2010.02710.x
Yellappa V, Lefèvre P, Battaglioli T, et al. Coping with tuberculosis and directly observed treatment: a qualitative study among patients from South India. BMC Health Serv Res 2016;16:283. DOI: https://doi.org/10.1186/s12913-016-1545-9
Yasobant S, Nazli Khatib M, Syed ZQ, et al. Health-related quality of life (HRQoL) of patients with tuberculosis: a review. Infect Dis Rep 2022;14:509-24. DOI: https://doi.org/10.3390/idr14040055
Rachmawati DS, Nursalam N, Hargono R, Widjanarko Otok B. Quality of life and subjective well-being modeling of pulmonary tuberculosis patients. J Public Health Res 2021;10:2180. DOI: https://doi.org/10.4081/jphr.2021.2180
Kumari Indira KS, Mathew N. TB related stigma and gender disparity among unaffected population in central Kerala, a survey. Indian J Tuberc 2023;70:168-75. DOI: https://doi.org/10.1016/j.ijtb.2022.03.028
Chiang SS, Zeng C, Roman-Sinche B, et al. Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru. Int J Tuberc Lung Dis 2023;27:754-60. DOI: https://doi.org/10.5588/ijtld.23.0104
Nuttall C, Fuady A, Nuttall H, et al. Interventions pathways to reduce tuberculosis-related stigma: a literature review and conceptual framework. Infect Dis Poverty 2022;11:101. DOI: https://doi.org/10.1186/s40249-022-01021-8

Ethics Approval

This study was approved by the institute’s Ethics committee vide letter no. Trg.9(310)2022/24733 dated 27-07-2022.

How to Cite

Garg, Kranti, Preeyati Chopra, Jasmin Garg, Deepak Goyal, Darshana KE, and Vishal Chopra. 2024. “Psychological Morbidity and Quality of Life of Patients With Pulmonary Tuberculosis”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2024.3171.

Similar Articles

<< < 1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.