“Socio-Demographic, Psychosocial Factors in MDR And XDR-Tb With Psychiatric Co Morbidities And Their Relation with Drug Adherence.”

Abstract

Aims and Objective: To find out socio demographic profile, prevalence, adherence, type and factors associated with psychopathology in patients of MDR-TB & XDR-TB. Methodology: All Indoor MDR & XDR-TB patients of a state general hospital in urban setting of western India during 1 year were enrolled. Hospital Anxiety and Depression Scale(HADS), Brief Psychiatric Rating Scale(BPRS), General Health Questionnaire(GHQ), Morisky 8-Item Medication Adherence Questionnaire(M8MAQ) were applied to assess anxiety and depression, psychosis, general health condition, treatment adherence respectively. Statistical Analysis was done to find out factors associated with psychopathology in MDR-TB & XDR-TB. Results:56% (n=84) of MDR vs 62.5% (n=16) of XDR patients had abnormal scores in HADS-A subscale ; 54.8% (n=84) of MDR vs 56.3% (n=16) of XDR patients had abnormal scores in HADS-D subscale.On HADS-A subscale patients with normal, borderline abnormal and abnormal scores had GHQ mean value 10.7, 19.33, and 27.40 respectively. On HADS-D subscale patients with normal, borderline abnormal and abnormal scores had GHQ mean value 11.17, 15.22, and 27.91 respectively. Only 2.4% were noted with hallucinatory behaviour in MDR TB who were on Cycloserine.In MDR vs XDR TB patients 46.4% vs 31% and 37.5% vs 18.8% had high and medium adherence respectively. In contrast 43.8% of XDR and 22.6% of MDR had low adherence. Association of depression and anxiety with variables of sociodemographic profile were found statistically insignificant. Conclusion: Illness is the only factor associated with anxiety and depression while variables like sex, occupation, marital status ,type of TB, adherence are not much important.