Psychological Distress in Patients of Multi Drug Resistant Tuberculosis

International Journal of Health Sciences and Research(2019)

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摘要
Introduction-Tuberculosis continues to be a major global health concern. Psychiatric disorder can present a great challenge in the management of patients with multidrug resistant tuberculosis (MDR-TB). Anxiety disorders and psychosis, can greatly impact patient quality of life, as well as physicians’ attitudes toward MDR-TB therapy. Successful control of psychiatric symptoms is therefore crucial not only for favorable patient outcome, but also for patients’ overall well-being. A patient of MDR Tuberculosis also suffers from significant stress, subclinical depression and anxiety symptoms. We intended to conduct a study aiming to analyze the patterns of psychiatric illnesses in the patients diagnosed as MDR tuberculosis in a tertiary care hospital. Methodology-Sixty patients of MDR TB underwent a detailed psychiatric evaluation by a consultant psychiatrist. Psychiatric diagnoses were considered as per ICD-10 DCR criteria. Hamilton Depression rating scale (HAM-D) was used to assess Depressive symptoms and Hamilton Anxiety Rating scale (HAM-A) was used to asses anxiety symptoms. Perceived Stress scale (PSS) was used to assess the perception of stress. The statistical analyses were conducted using Statistical package for the social sciences (SPSS version 16) software. The statistical significance was defined at P u003c 0.05. Results-Most common psychiatric diagnosis in our study was Depressive disorder (28.3%) followed by anxiety disorders (16.7%). 5 (8.3%) MDR patients also suffered from Psychotic Disorders. 20% of patients had perceived very high level of stress. Conclusion-This study has revealed significant psychological stress and psychiatric comorbidity associated with MDR-TB patients causing significant social and financial challenges to their families. There is a need for psychosocial support of MDR-TB patient and their caregivers to mitigate the negative effects of stigma, and to manage the associated psychological stressors.
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