Understanding the Burden: Prevalence and Predictors of Depression and Anxiety among Multidrug-Resistant Tuberculosis Patients and their Household Contacts

Abstract

Background: MDR-TB presents a significant challenge to global health, not only due to its resistance to standard tuberculosis treatment but also due to its profound psychosocial impacts. Yet, the mental health dimensions of MDR-TB remain underexplored, particularly among affected individuals and their close contacts. Objective: This study was conducted with the aim to determine the rate and predictors responsible for depression and anxiety among MDR-TB family and their household contacts. Methodology: A cross-sectional analytical study was conducted in the Department of Pulmonology, Lady Reading Hospital Peshawar, Pakistan from January 2017 to March 2021. A total of 1000 study cases were included in this study, of which 600 were Multidrug-Resistant TB patients and 400 were household contacts of these patients. For study purposes different scales were used like the PHQ-9 scale for depression, the HAM-A scale for anxiety, the CIASS scale for stigma, and the MSPSS scale for social support. All data were analyzed through SPSS v 23. Results: In the present study, 57.0% were male and 63% of the study cases were married. Among diseased cases, 36% had low income and 28.3% had chronic conditions. The mean disease severity score of MDR-TB patients was 6.9. Among household contacts, 67.5% were from a low-income background, and 27.5% had chronic conditions. Prevalence of depression was 36.6% among MDR-TB patients and 17.5% among household contacts, with frequency of anxiety being 46.6% and 20%, respectively. Responsible factors were older age, female gender, lower financial status and disease-related stigma. Conclusion: The study highlights a significant prevalence of two of the main psychiatric illnesses among the study cases which emphasises the urgent need for enhanced collaboration between TB programs and mental health services. Addressing sociodemographic factors, perceived stigma, and disease severity is crucial for effective management. Integrating mental health support into TB care frameworks and adopting family-centred approaches are vital steps in alleviating the burden of both TB and mental health issues in affected communities.