Publication:

Occurrence of psychiatric disorders in the patients of multi drug resistant tuberculosis under treatment

Background Tuberculosis (TB) is considered as one of the leading causes of mortality worldwide. Even though fatality of TB is well known, treatment non-adherence is major barrier related to management of TB. Studies have shown that there is strong association between psychiatric disorders and treatment nonadherence to TB. Psychiatric issues present a challenge in the treatment of patients with multi drug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs require aggressive management for better management of TB. The objective of the present endeavour was to study the occurrence of psychiatric complications in patients of MDR-TB during treatmentMethods: Patients of MDR-TB registered at PMDT centre situated at a tertiary level hospital were screened for psychiatric disorder by using GHQ-12 and assessment was done using structured clinical interview for DSM-IV-TR (SCID-1) research version. Diagnosis of psychiatric disorder was made on the basis of DSM-IV-TR.

Results Psychiatric disorders were already present in 8 (6.15%) patients before the start of MDR-TB treatment and development of psychiatric disorder in 12 (9.23%) patients after initiation of the treatment. Depressive disorder (n=9; 6.9%), anxiety disorder (n=5; 3.8%) and psychosis (n=4; 3.1%) were most frequent psychiatric disorders.

Conclusions GHQ-12 was found to be very useful screening instrument for detection of psychiatric disorders. The regimen IV anti tubercular drugs used for the treatment of MDR-TB drug resistant tuberculosis, significantly increases the risk of development of psychiatric disorders.