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. 2022 Feb 11;17(2):e0263759.
doi: 10.1371/journal.pone.0263759. eCollection 2022.

Psychiatric comorbidities among patients with complex drug-resistant tuberculosis in Mumbai, India

Chinmay Laxmeshwar  1 , Mrinalini Das  1 , Taanya Mathur  1 , Tarun Israni  1 , Santosh Jha  1 , Aparna Iyer  1 , Mabel Morales  1 , Tom Decroo  2 , Tinne Gils  2 , Gabriella Ferlazzo  3 , Kleio Iakovidi  3 , Mariana Garcia  3 , Petros Isaakidis  3
Affiliations

Psychiatric comorbidities among patients with complex drug-resistant tuberculosis in Mumbai, India

Chinmay Laxmeshwar et al. PLoS One. .

Erratum in

Abstract

Background: People with drug-resistant tuberculosis (DR-TB) are known to suffer from many mental-health disorders. This study aims to describe the proportion of patients diagnosed with psychiatric comorbidities, the different psychiatric diagnoses made, and treatment outcomes among DR-TB patients with or without psychiatric comorbidity and initiated on DR-TB treatment between January 2012 and March 2019 at Médecins Sans Frontières independent clinic in Mumbai, India.

Methods: This is a retrospective study using routinely collected clinical data. DR-TB care included individualised treatment, psychosocial support, and integrated psychiatric care.

Results: During the study period, 341 DR-TB patients were enrolled, with a median age of 25 years (IQR:20.0-36.5 years), 185 (54.2%) females, 143 (41.9%) with PreXDR-TB, and 140 (41.0%) with XDR-TB. All 341 patients were screened by a counsellor, 119 (34.9%) were referred for psychiatric evaluation, and 102 (29.9% of 341) were diagnosed with a psychiatric comorbidity. Among 102 diagnosed with a psychiatric comorbidity, 48 (47.0%) were diagnosed at baseline, and 86 (84.3%), or 25.2% of all 341 patients enrolled, were treated with psychotropic drugs. Depressive disorders were diagnosed in 49 (48.0%), mixed anxiety and depression in 24 (23.5%), neurocognitive disorders and anxiety in five (4.9%), and medication induced psychosis in two (2.0%). No anti-TB drugs were significantly associated with psychiatric comorbidities developed during treatment. Of 102 DR-TB patients with a psychiatric comorbidity, 75.5% (77) had successful DR-TB treatment outcomes, compared to 61.1% (146/239) not diagnosed with a psychiatric comorbidity (p = 0.014).

Conclusion: In our setting, among people started on DR-TB treatment, and with a complex TB resistance profile, about one in three patients experienced a psychiatric comorbidity, of which half developed this comorbidity during treatment. With comprehensive psychiatric care integrated into DR-TB care delivery, treatment outcomes were at least as good among those with psychiatric comorbidities compared to those without such comorbidities.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Cascade of psychiatric care among drug-resistant tuberculosis patients enrolled at Médecins Sans Frontières Mumbai clinic between January 2012 and March 2019.
See this image and copyright information in PMC

References

    1. World Health Organization. Global Tuberculosis Report 2020. 2020. Available: http://library1.nida.ac.th/termpaper6/sd/2554/19755.pdf
    1. Walker IF, Baral SC, Wei X, Huque R, Khan A, Walley J, et al.. Multidrug-resistant tuberculosis treatment programmes insufficiently consider comorbid mental disorders. Int J Tuberc Lung Dis. 2017;21: 603–609. doi: 10.5588/ijtld.17.0135 - DOI - PubMed
    1. Vega P, Sweetland A, Acha J, Castillo H, Guerra D, Smith Fawzi MC, et al.. Psychiatric issues in the management of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis. 2004;8: 749–759. - PubMed
    1. Isaakidis P, Varghese B, Mansoor H, Cox HS, Ladomirska J, Saranchuk P, et al.. Adverse events among HIV/MDR-TB co-infected patients receiving antiretroviral and second line anti-TB treatment in Mumbai, India. PLoS One. 2012;7. doi: 10.1371/journal.pone.0040781 - DOI - PMC - PubMed
    1. Doherty AM, Kelly J, McDonald C, O’Dywer AM, Keane J, Cooney J. A review of the interplay between tuberculosis and mental health. Gen Hosp Psychiatry. 2013;35: 398–406. doi: 10.1016/j.genhosppsych.2013.03.018 - DOI - PubMed

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