Assessment of Depression among Pulmonary Tuberculosis Patients: A Cross-Sectional Study from Pakistan.

Abstract

Background: Depression is a condition that is often co-morbid to tuberculosis and can lead to increased morbidity and mortality associated with tuberculosis. The current prevalence of depression worldwide among individuals receiving treatment for TB ranged from 11.3% to 80.2%, with a mean weighted prevalence of 48.9%. The aim of the current study was to assess depression among tuberculosis patients in Pakistan. Methods A descriptive cross-sectional study design was used to evaluate depression among pulmonary tuberculosis patients in Pakistan. All the public and private tertiary healthcare facilities treating TB located in Rawalpindi and Islamabad were included in the study. Patient health questionnaire-9 (PHQ-9) was used to collect data from 382 patients of pulmonary tuberculosis. Non-parametric tests, Mann-Whitney and Kruskal-Wallis, were performed to find out the difference among different variables. Results & Conclusion: Kruskal-Wallis and Mann-Whitney (p ≥ 0.05) were performed to find out the differences among different variables. Significant difference between different income levels (p=0.002), duration of treatment (p=0.01), phase of treatment (p=0.03) and type of treatment (p=0.001) were observed. Moderate depression was observed among patients at baseline and had duration of treatment less than a month. The present study concluded that majority of patients suffering from tuberculosis suffered from some sort of depression. This depression was more evident at baseline phase of therapy. Patients undergoing directly observed therapy appeared to be more depressed due to increased stigma along with increase in financial burden. Counseling and psychotherapy can play a massive role in combating depression and improving medication adherence in TB patients.