World Health Day 2017: Let’s talk about depression and TB
The prevalence of mental disorders among people with TB is estimated to be between 40-70%.
Geneva ¦ 07 April 2017 - Depression is today the leading cause of ill health and disability worldwide, with more than 300 million people affected - an increase of more than 18% between 2005 and 2015. These new alarming estimates were released by the World Health Organization (WHO) in the lead-up to World Health Day on 7 April, dedicated to the theme “Depression: Let’s talk”. The year-long campaign promotes the goal that more people with depression both seek and get help.
The prevalence of mental disorders, including depression and
anxiety disorders, among people with TB is estimated to be
between 40% and 70%. There are several factors at play. Patients
with mental disorders are at an increased risk exposure of TB
infection with higher rates of homelessness, and residence in
shelters and group homes. Patients with mental disorders also
carry other risk factors for TB, including smoking, poor
nutrition and co-morbidities such as diabetes and HIV infection.
In addition, people living with TB and mental disorders are less
likely to seek health care and may be less able to adhere to
treatment, with consequent adverse treatment outcomes including
morbidity, mortality, drug resistance and ongoing disease
transmission.
“Depression has been an
invisible burden for people with TB. The risk of people with
mental disorders being prone to developing TB, or the mental
well-being of TB patients during their treatment has often been
overlooked”, said Dr Mario Raviglione, Director of the WHO
Global TB Programme. “We need to urgently address the
mental and physical aspects of TB simultaneously if we want to
improve well-being as well as treatment outcomes, ensuring no
one is left behind in the fight to end TB”.
Adverse impact of TB treatment on mental health
Several anti-TB medications, such as cycloserine,
may precipitate more severe forms of mental
disorders—including major depression, anxiety, or
psychosis. There is also evidence of increased risk of suicide
behavior among people living with TB, including among women,
those who are being retreated for TB, misusing alcohol, with
previous psychological distress or post-traumatic stress
disorders.
“We need to develop and
implement guidelines to screen and treat depression among
persons being treated for TB, and work closely with patients to
improve their illness perceptions”, said Dr Shekhar
Saxena, Director of the Department of Mental Health and
Substance Abuse at WHO. “Both national TB programmes and
programmes addressing mental health issues in countries need to
collaborate closely to make this a reality.”
Synergistic
and joint actions against TB and noncommunicable diseases
including mental health, will be one of the themes addressed at
the upcoming
WHO Global Ministerial Conference: “Ending Tuberculosis
in the Sustainable Development Era: A Multisectoral
Response”
in Moscow, 16-17 November.
