Depression comorbid with tuberculosis and its impact on health status: cross-sectional analysis of community-based data from 48 low- and middle-income countries.
Por:
Koyanagi A, Vancampfort D, Carvalho AF, DeVylder JE, Haro JM, Pizzol D, Veronese N and Stubbs B
Publicada:
28 nov 2017
Ahead of Print:
28 nov 2017
Categoría:
Medicine (miscellaneous)
Resumen:
BACKGROUND: Depression in tuberculosis increases the risk for adverse health outcomes. However, little is known about comorbid depression and tuberculosis in the general population. Thus, we assessed the association between depression and tuberculosis, and the decrements in health status associated with this comorbidity in 48 low- and middle-income countries. METHODS: Cross-sectional, community-based data from the World Health Survey on 242,952 individuals aged = 18 years were analyzed. Based on the World Mental Health Survey version of the Composite International Diagnostic Interview, past 12-month depression was categorized into depressive episode, brief depressive episode, subsyndromal depression, and no depression. Health status across six domains (cognition, interpersonal activities, sleep/energy, self-care, mobility, pain/discomfort) was assessed. Multivariable logistic and linear regression analyses were performed to assess the associations. RESULTS: The prevalence of depressive episode among those with and without tuberculosis was 23.7% and 6.8%, respectively (P < 0.001). Tuberculosis was associated with a 1.98 (95% CI 1.47-2.67), 1.75 (95% CI 1.26-2.42), and 3.68 (95% CI 3.01-4.50) times higher odds for subsyndromal depression, brief depressive episode, and depressive episode, respectively. Depressive episode co-occurring with tuberculosis was associated with significantly worse health status across all six domains compared to tuberculosis alone. Interaction analysis showed that depression significantly amplifies the association between TB and difficulties in self-care but not in other health domains. CONCLUSIONS: Depression is highly prevalent in adults with tuberculosis, and is associated with worse health status compared to tuberculosis without depression. Public health efforts directed to the recognition and management of depression in people with tuberculosis may lead to better outcomes.
Filiaciones:
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Vancampfort D:
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
Carvalho AF:
Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
DeVylder JE:
Fordham University, Graduate School of Social Service, New York, NY, USA
Haro JM:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
Pizzol D:
Operation Research Unit, Doctors with Africa, Maputo, Mozambique
Veronese N:
Institute for clinical Research and Education in Medicine (IREM), Padova, Italy
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
Stubbs B:
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
gold, Green Published, Green Accepted
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