Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries
Open accessAbstract
Background: There is increasing evidence that the substantial global burden of disease for tuberculosis unfolds in concert with dimensions of common mental disorders. Person-centred care holds much promise to ameliorate these comorbidities in low-to-middle income countries (LMICs) and emerging economies. Towards this end, this paper aims to review 1) the nature and extent of tuberculosis and common mental disorder comorbidity and 2) person-centred tuberculosis care in low-to-middle income countries and emerging economies. Main text: A scoping review of 100 articles was conducted of English-language studies published from 2000 to 2019 in peer-reviewed and grey literature, using established guidelines, for each of the study objectives. Four broad tuberculosis/mental disorder comorbidities were described in the literature, namely alcohol use and tuberculosis, depression and tuberculosis, anxiety and tuberculosis, and general mental health and tuberculosis. Rates of comorbidity varied widely across countries for depression, anxiety, alcohol use and general mental health. Alcohol use and tuberculosis were significantly related, especially in the context of poverty. The initial tuberculosis diagnostic episode had substantial socio-psychological effects on service users. While men tended to report higher rates of alcohol use and treatment default, women in general had worse mental health outcomes. Older age and a history of mental illness were also associated with pronounced tuberculosis and mental disorder comorbidity. Person-centred tuberculosis care interventions were almost absent, with only one study from Nepal identified. Conclusions: There is an emerging body of evidence describing the nature and extent of tuberculosis and mental disorders comorbidity in low-to-middle income countries. Despite the potential of person-centred interventions, evidence is limited. This review highlights a pronounced need to address psychosocial comorbidities with tuberculosis in LMICs, where models of person-centred tuberculosis care in routine care platforms may yield promising outcomes.
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A recent scoping review found varying prevalence rates of anxiety amongst Tuberculosis patients, ranging from 2% to 27%.
“A recent scoping review found varying prevalence rates of anxiety amongst Tuberculosis patients, ranging from 2% to 27%.6”
From Pharmacological or non-pharmacological interventions for treatment of common mental disorders associated with Tuberculosis: A systematic review (2021) · cites this paper as [6]
The Results section reports that anxiety-related symptoms among TB patients varied, with a low of 2% in India. But it gives the upper end as 47% in Pakistan, not 27%; Table 2 lists 47.2% for that study. (LLM, conf=0.90)
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- Authors
- Janse Van Rensburg, A., Dube, A., Curran, R., Ambaw, F., Murdoch, J., Bachmann, M., Petersen, I., & Fairall, L.
- Affiliations
- University of Cape Town (ZA)
- Bahir Dar University (ET)
- University of East Anglia (GB)
- University of KwaZulu-Natal (ZA)
- ORCID
- Venue
- Infectious Diseases of Poverty
- Published
- 2020-01-15
- Volume
- 9
- Issue
- 1
- Pages
- 4-4
- ISSN
- 2049-9957 (ISSN-L)
- PMC
- PMC6964032
- OpenAlex
- W3002282706
- Cited by
- 142
- References
- 126
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 33 · 2023: 42 · 2022: 12 · 2021: 23 · 2020: 5 · 2017: 1
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Infectious Diseases of Poverty (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Open University of Cape Town (University of Cape Town) (submittedVersion)
- Greater South Information System
- Funders
- National Institute for Health Research (GHRU 16/136/54)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- tuberculosis, common mental disorders, comorbidities, depression, anxiety, alcohol consumption, person-centred care, low- and middle-income countries, BRICS countries, treatment default, gender differences, psychosocial burden, poverty
- MeSH terms
- Mental Disorders, Developing Countries, Health Services Needs and Demand, Humans, Tuberculosis, Comorbidity, Patient-Centered Care
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