Depression: A Neglected Comorbidity in Patients with Tuberculosis

Background: Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in India. Depression among TB patients is a common comorbidity which is often unrecognised and untreated. It constitutes a major risk factor for higher default rates due to non-adherence to the treatment, thereby affecting the treatment outcome.

Aim of the study: This study was carried out to assess the prevalence of depression and it's severity among TB patients.

Materials and methods: It was a cross-sectional, prospective and observational study conducted in TB patients, diagnosed and registered under directly observed treatment system (DOTS) at a tertiary care hospital in Bangalore from June 2016 to October 2016. Depression was assessed using Patient Health Questionnaire (PHQ-9).

Results: Out of the total two hundred sixty two (262) TB patients, 107 patients were found to have depression. The prevalence was found to be 40.83%. Mild to moderate depression was observed in 71.02% of the patients. Predominantly, depression was seen in the age group 20- 39 years (49.53%). Males had significant depression (p = 0.021). Patients with pulmonary TB (80.37%) were found to have higher depression than patients with extrapulmonary TB (19.62%). Depression was more during the first four months of the therapy. Significant depression was found among patients who were alcoholics (p = 0.027). There was no statistically significant association of depression with comorbidities.

Conclusion: There is high prevalence of depression among TB patients. It is more common in males and alcoholics. Patients who are in the first four months of the treatment are more likely to have depression. There should be regular screening of the patients with TB for psychiatric illness during the course of the treatment for better treatment compliance and outcome.