Common mental disorders associated with tuberculosis: a matched case-control study

• Published in: PloS one 2014-06, Vol.9 (6), p.e99551-e99551
• Main Authors: de Araújo, Gleide Santos, Pereira, Susan Martins, dos Santos, Darci Neves, Marinho, Jamocyr Moura, Rodrigues, Laura Cunha, Barreto, Mauricio Lima
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alcoholism; Biology and Life Sciences; Case-Control Studies; Control methods; Data collection; Diagnosis; Drug abuse; Epidemiology; Female; Health services; HIV; Human immunodeficiency virus; Humans; Infectious diseases; Male; Males; Medical diagnosis; Medicine and Health Sciences; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - microbiology; Mental health; Microscopy; Middle Aged; Multivariate analysis; Patients; Population; Population studies; Primary care; Public health; Questionnaires; Regression analysis; Research and Analysis Methods; Social Sciences; Statistical analysis; Statistical tests; Studies; Tuberculosis; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - psychology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0099551

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. The objective of this study was to investigate the association between common mental disorders and tuberculosis. 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. 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). 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.