Depression among TB patients and associated factors in Kathmandu Valley, Nepal
Open accessAbstract
Introduction: When tuberculosis (TB) and depression co-occur, there is greater risk for comorbidities, disability, suffering, and health-related costs. Depression is also associated with poor treatment adherence in patients with TB. The major aim of this study was to assess the symptoms of depression and associated factors among TB patients currently receiving directly observed treatment short-course (DOTS) treatment. Methods: A cross-sectional study was conducted among TB patients currently undergoing treatment in 27 DOTS centers in three districts of Kathmandu Valley. The study included 250 TB patients within 2 months of treatment initiation, aged 18 years and above. The previously validated Nepali Patient Health Questionnaire (PHQ-9) was used to screen for depression and semi-structured interviews were conducted to collect socio-demographic information and other factors related to TB and/or depression. Data analysis was conducted using IBM SPSS Statistics version 20. Results: The study found the mean PHQ Score to be 2.84 (s.d. 4.92, range 0–25). Among the respondents, 10% (n = 25) had PHQ-9 scores ⩾10, suggestive of probable depression. Multivariate linear regression indicated that depressive symptoms were significantly associated with being separated/widowed/divorced (p = 0.000) and having lower education (0.003). In addition, smoking (p = 0.02), alcohol use (p = 0.001), and experience of side effects from TB medications (p = 0.001) were risk factors for higher PHQ-9 scores. Conclusions: Our findings suggest that patients on TB treatment have higher risk of depression and efforts should be made by the National Tuberculosis Program to address this issue.
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ACT can reduce patients' depression during treatment.
“This result agrees with a study randomly controlled trial showing that ACT could reduce patients’ depression during their treatment.24”
From The effects of acceptance and commitment therapy on psychosocial impact and adherence of multidrug-resistant tuberculosis patients (2022) · cites this paper as [24]
The Methods (Study design and population; page unavailable) explicitly describe a descriptive cross-sectional study, not a randomized controlled trial. The study assessed depression among TB patients receiving treatment; our copy does not report an ACT intervention or a reduction in depression caused by ACT. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredDepression can have negative impacts on patients' quality of life, immunity, self-care, and medication adherence.
“Depression can have negative impacts on the patients’ quality of life, immunity, self-care, and medication adherence.24”
From The effects of acceptance and commitment therapy on psychosocial impact and adherence of multidrug-resistant tuberculosis patients (2022) · cites this paper as [24]
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- Authors
- Shrestha, P., Subba, U. K., Brouwer, M., & Sweetland, A. C.
- Affiliations
- Tri-Chandra Multiple Campus (NP)
- New York State Psychiatric Institute (US)
- Corresponding author
- Shrestha, P.
- Venue
- Global Mental Health
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020
- Volume
- 7
- Pages
- e4-e4
- ISSN
- 2054-4251 (ISSN-L)
- PMC
- PMC7003518
- OpenAlex
- W3002723869
- Cited by
- 11
- References
- 32
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 3
- FWCI
- 0.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institute of Mental Health (K01MH104514)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- depression, tuberculosis, depressive symptoms, directly observed treatment short course, risk factors, marital status, educational attainment, smoking, alcohol consumption, PHQ-9, Kathmandu Valley
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