Common Mental Disorders Associated with Tuberculosis: A Matched Case-Control Study
Open accessAbstract
INTRODUCTION: Despite the availability of treatment and a vaccine, tuberculosis continues to be a public health problem worldwide. Mental disorders might contribute to the burden of the disease. OBJECTIVE: The objective of this study was to investigate the association between common mental disorders and tuberculosis. METHODS: A matched case-control study was conducted. The study population included symptomatic respiratory patients who attended three referral hospitals and six community clinics in the city of Salvador, Brazil. A doctor's diagnosis defined potential cases and controls. Cases were newly diagnosed tuberculosis cases, and controls were symptomatic respiratory patients for whom tuberculosis was excluded as a diagnosis by the attending physician. Cases and controls were ascertained in the same clinic. Data collection occurred between August 2008 and April 2010. The study instruments included a structured interview, a self-reporting questionnaire for the identification of common mental disorders, and a questionnaire for alcoholism. An univariate analysis included descriptive procedures (with chi-square statistics), and a multivariate analysis used conditional logistic regression. RESULTS: The mean age of the cases was 38 years, and 61% of the cases were males. After adjusting for potential confounders, the odds of tuberculosis were significantly higher in patients diagnosed with a common mental disorder (OR: 1.34; 95% CI 1.05-1.70). CONCLUSION: There appears to be a positive and independent association between common mental disorders and tuberculosis; further epidemiological studies are required to increase our understanding of the possible biological and social mechanisms responsible for this association. Independent of the direction of the association, this finding has implications for the provision of care for mental disorders and for tuberculosis.
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The relationship between depression and TB is bidirectional.
“The relationship between depression and TB is bidirectional.”
From Pharmacological or non-pharmacological interventions for treatment of common mental disorders associated with Tuberculosis: A systematic review (2021) · cites this paper as [7]
The Discussion describes plausible pathways in both directions between TB and mental illness, including effects of stress on illness and effects of TB diagnosis on mental health. But the study examined common mental disorders, not depression specifically, and the Conclusions call for cohort studies to establish the direction of causality; it does not establish a bidirectional relationship. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDepression is associated with adverse outcomes in TB such as poor functional impairment, poor adherence to medication and self-care regimens, increased medical symptom burden and increased mortality.
“Depression is associated with a range of adverse outcomes in TB such as poor functional impairment, poor adherence to medication and self-care regimens, increased medical symptom burden and increased mortality.7,8”
From Pharmacological or non-pharmacological interventions for treatment of common mental disorders associated with Tuberculosis: A systematic review (2021) · cites this paper as [7]
The Introduction says common mental disorders can impair self-care, work capacity and treatment adherence; the Discussion says their association with TB could reduce adherence and quality of life. But the paper studies common mental disorders rather than depression specifically, and it does not establish increased medical symptom burden or mortality as outcomes of depression in TB. Its mortality statement concerns the risks of poor adherence. Section labels are available, but page numbers are not. (LLM, conf=0.86)
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- Authors
- Araújo, G. S. D., Pereira, S. M., Santos, D. N. D., Marinho, J. M., Rodrigues, L. C., & Barreto, M. L.
- Affiliations
- Universidade Federal da Bahia (BR)
- Escola Bahiana de Medicina e Saúde Pública (BR)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Araújo, Gleide Santos de
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-06-17
- Volume
- 9
- Issue
- 6
- Pages
- e99551
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4061008
- OpenAlex
- W2017422089
- Cited by
- 32
- References
- 27
- Citations by year
- 2026: 3 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 1 · 2020: 2 · 2019: 7 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 3
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (publishedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- 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, depression, anxiety, alcoholism, psychiatric comorbidity, respiratory symptoms, tuberculosis risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Humans, Male, Middle Aged, Tuberculosis, Pulmonary, Case-Control Studies, Young Adult
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