Abstract
ObjectiveAs the rates of TB world over have increased during the past 10 years, there has been a growing awareness of depression and its role in the outcome of chronic disorders. Though depression is common in patients with TB no study as yet has examined the prevalence of depression in this group in Pakistan. We aimed to determine the presence of depression, anxiety and illness perceptions in patients suffering from Tuberculosis (TB) in Pakistan.Methods108 consecutive outpatients with tuberculosis completed the Hospital Anxiety and Depression scale (HADS) and the Illness Perception Questionnaire (IPQ).ResultsOut of 108 patients, 50 (46.3%) were depressed and 51 (47.2%) had anxiety. Raised depression and anxiety scores were associated with an increase in the number of symptoms reported (HADS Depression: r = 0.346, p = < 0.001), more serious perceived consequences (HADS Depression: r = 0.279, p = 0.004, HADS Anxiety: r = 0.234, p = 0.017) and less control over their illness (HADS Depression: r = 0.239, p = 0.014, HADS Anxiety: r = 0.271, p = 0.005).ConclusionWe found that about a half of patients in our sample met the criteria for probable depression and anxiety based on HADS score. Negative illness perceptions were clearly related to reports of mood symptoms. As depression and lack of perceived control over illness in those suffering from tuberculosis are reported to be independent predictors of poor adherence further studies to investigate their relationship with medication adherence are required.
Highlights
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis and is one of the leading causes of mortality worldwide [1,2]
[5] The factors determining compliance with TB treatment regimes are not well understood as yet, over the years one of the main efforts in reducing TB prevalence has been directed towards Direct Observed Therapy (D.O.T.) to enhance compliance to TB medication, disappointingly, the evidence suggests that D.O.T. shows little advantage over self-treatment [6]
The self-regulation model (SRM) hypothesizes that beliefs about the identity of the illness, the perceived consequences of the illness, the likely causes of the illness, a likely time line of how long the illness will last and the potential for control or cure [8] are the beliefs guiding the responses of illness
Summary
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis and is one of the leading causes of mortality worldwide [1,2]. Clinical Practice and Epidemiology in Mental Health 2008, 4:4 http://www.cpementalhealth.com/content/4/1/4 that 5.7 million of Pakistan's current population of 144 million suffer from TB, with 260, 000 new cases occurring each year [3]. One of the main causes of treatment failure and rise in the prevalence of TB is due to poor treatment adherence [5] The factors determining compliance with TB treatment regimes are not well understood as yet, over the years one of the main efforts in reducing TB prevalence has been directed towards Direct Observed Therapy (D.O.T.) to enhance compliance to TB medication, disappointingly, the evidence suggests that D.O.T. shows little advantage over self-treatment [6]. The self-regulation model (SRM) [7] suggests that the illness beliefs of an individual will guide their coping strategies. The SRM hypothesizes that beliefs about the identity of the illness, the perceived consequences of the illness, the likely causes of the illness, a likely time line of how long the illness will last and the potential for control or cure [8] are the beliefs guiding the responses of illness
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