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Cited by 130Tuberculosis Research and EpidemiologyMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The relationship between anxiety, depression and illness perception in tberculosis patients in Pakistan

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Husain, Mohammed O, Dearman, Sam P, Chaudhry, Imran B, Rizvi, Nadeem, Waheed, Waquas·2008·Clinical Practice and Epidemiology in Mental Health
DOI 10.1186/1745-0179-4-4PMC PMC2288599
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Abstract

OBJECTIVE: As 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. METHODS: 108 consecutive outpatients with tuberculosis completed the Hospital Anxiety and Depression scale (HADS) and the Illness Perception Questionnaire (IPQ). RESULTS: Out 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). CONCLUSION: We 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.

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  • Depression and anxiety are linked to delayed diagnosis, missed doses, treatment interruption, and poorer microbiological outcomes.

    “depression and anxiety in particular have been linked to delayed diagnosis, missed doses, treatment interruption, and poorer microbiological outcomes [10,11,12].”

    From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [11]

    The Introduction (page unavailable) reports higher depression and anxiety among poorly compliant TB patients and an association between depression and poor adherence. The Discussion (page unavailable) says the study’s findings may contribute to poor compliance, but the paper does not establish links to delayed diagnosis, specifically missed doses or treatment interruption, or microbiological outcomes. (LLM, conf=0.88)

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  • Patients with depression or anxiety are more likely to report difficulties adhering to TB treatment and to experience poorer outcomes.

    “Patients with depression or anxiety are more likely to report difficulties adhering to treatment and to experience poorer outcomes [10,11].”

    From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [11]

    The Introduction reports higher depression and anxiety rates among poorly compliant TB patients in a UK sample, supporting the adherence part of the claim. The Discussion says poor adherence can worsen clinical outcomes and suggests treating depression may improve TB outcomes, but it does not establish that TB patients with depression or anxiety experienced poorer outcomes. (LLM, conf=0.86)

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  • Pre-existing or comorbid mental disorders may compromise help-seeking and adherence by reducing motivation, impairing concentration and memory for daily medication routines, increasing risky behaviors such as alcohol or drug use, and weakening the patient-provider relationship.

    “pre-existing or comorbid mental disorders may compromise help-seeking and adherence by reducing motivation, impairing concentration and memory for daily medication routines, increasing risky behaviors such as alcohol or drug use, and weakening the patient–provider relationship”

    From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [11]

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Cites

1 retracted

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Research works printed but not linked: 3

  1. Volmink J Garner P Interventions promoting adherence to tuberculosis Cochrane Database Syst Rev 2000 4 CD000010 11034666
  2. Dearman SP Waheed W Whitehead Dickens C Role of depression and illness perception in poor compliance in Tuberculosis European Association for Consultation-Liaison Psychiatry and Psychosomatics conference abstracts, Berlin 2004
  3. Purhohit DR Purhoit SD Dhariwal ML Incidence of Depression in Hospitalised T.B. Patients Indian Journal of Tuberculosis 1978 25 3 147 151

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Authors
Husain, M. O., Dearman, S. P., Chaudhry, I. B., Rizvi, N., & Waheed, W.
Affiliations
  • St George's, University of London (GB)
  • Pakistan Institute of Learning and Living (PK)
  • Jinnah Postgraduate Medical Center (PK)
  • Lancashire Care NHS Foundation Trust (GB)
Corresponding author
Husain, Mohammed O
ORCID
Venue
Clinical Practice and Epidemiology in Mental Health
Publisher
Bentham Science Publishers Ltd.
Published
2008
Volume
4
Issue
1
Pages
4
ISSN
1745-0179 (ISSN-L)
DOI
10.1186/1745-0179-4-4
PMC
PMC2288599
OpenAlex
W1994947459
Cited by
130
References
21
Citations by year
2026: 4 · 2025: 5 · 2024: 16 · 2023: 7 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 7 · 2015: 9 · 2014: 5 · 2013: 9 · 2012: 5
FWCI
3.23
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Clinical Practice and Epidemiology in Mental Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
tuberculosis, depression, anxiety, illness perception, perceived control, perceived consequences, medication adherence

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