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Psychiatric issues in the management of patients with multidrug-resistant tuberculosis

By Sophie Beauvais | 28 Mar, 2011

INTRODUCTION: Psychiatric issues present a challenge in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs and psychosocial factors require aggressive management.

SETTING: A community-based non-governmental health organization in Lima, Peru.

OBJECTIVE: To review the literature for psychiatric complications associated with anti-tuberculosis medications, to describe the incidence and prevalence of depression, anxiety and psychosis among individuals receiving MDR-TB therapy, and to detail the management approach used in this cohort.

METHODS: A retrospective case series was performed among the first 75 patients to receive individualized MDR-TB therapy in Lima, Peru, between 1996 and 1999.

RESULTS: Baseline depression and baseline anxiety were observed in respectively 52.2% and 8.7% of this cohort. Most individuals with baseline depression experienced improvement of depressive symptoms during the course of TB therapy. The incidence of depression, anxiety and psychosis during MDR-TB treatment was 13.3%, 12.0% and 12.0%, respectively. While the majority of individuals with depression, anxiety and psychosis required psychiatric pharmacotherapy, cycloserine was successfully continued in all but one case.
CONCLUSION: Psychiatric comorbidities are not a contraindication to MDR-TB therapy. Management of psychiatric complications is possible without compromising anti-tuberculosis treatment.

Free full text available on Ingenta Connect (see link)

Attached resource:
  • Psychiatric issues in the management of patients with multidrug-resistant tuberculosis (external URL)

    Link leads to: http://www.ingentaconnect.com/content/iuatld/ijtld/2004/00000008/00000006/art00011?token=005c1b8f22a1af496dd7b76504c486634252c3a566c2d406a765e6a332b25757d5c4f6d4e227a0de1e2c7bd00ca1

    Summary: INTRODUCTION: Psychiatric issues present a challenge in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs and psychosocial factors require aggressive management.

    SETTING: A community-based non-governmental health organization in Lima, Peru.

    OBJECTIVE: To review the literature for psychiatric complications associated with anti-tuberculosis medications, to describe the incidence and prevalence of depression, anxiety and psychosis among individuals receiving MDR-TB therapy, and to detail the management approach used in this cohort.

    METHODS: A retrospective case series was performed among the first 75 patients to receive individualized MDR-TB therapy in Lima, Peru, between 1996 and 1999.

    RESULTS: Baseline depression and baseline anxiety were observed in respectively 52.2% and 8.7% of this cohort. Most individuals with baseline depression experienced improvement of depressive symptoms during the course of TB therapy. The incidence of depression, anxiety and psychosis during MDR-TB treatment was 13.3%, 12.0% and 12.0%, respectively. While the majority of individuals with depression, anxiety and psychosis required psychiatric pharmacotherapy, cycloserine was successfully continued in all but one case.
    CONCLUSION: Psychiatric comorbidities are not a contraindication to MDR-TB therapy. Management of psychiatric complications is possible without compromising anti-tuberculosis treatment.

    Free full text available on Ingenta Connect (see link)

    Source: International Journal of Tuberculosis and Lung Disease

    Publication Date: June 1, 2004

    Language: English

    Keywords: anxiety, Clinical Assistance, cycloserine, Depression, Program Management, psychosis, Publications & Research

 

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