Tuberculosis disease and all the disruption and stress that goes along with it can take a toll on someone’s mental health, and mental health problems can in turn make someone more vulnerable to TB.
explores the complex links between mental health and TB.
“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.
“A pre-existing mental health disorder can increase your risk of developing TB because it can have a negative impact on your immune system. TB treatment can cause mental health symptoms/disorders. Certain groups of people are at an increased risk of mental health disorders, particularly depression, and TB – such as homeless people, people who misuse drugs and/or alcohol, or people living in poverty and/or malnutrition,” she says.
Furin says any treatment that lasts for months can be a challenge. TB treatment currently takes a minimum of six months to complete. “Fluoroquinolones and cycloserine can also cause psychosis, for which isoniazid is more rarely thought to be the cause. If depression is significant in people with TB, a trial of antidepressant therapy can be provided and or psychiatric consultation. It is advised that should depression not improve after the trial of antidepressant therapy, then cycloserine and possibly also ethionamide should be stopped,” she says.
“TB can cause a great deal of suffering, and much of this suffering is from the mental and socio-economic stressors people have,” she adds. “There is a need to make sure we equip people to address these issues as well, either through supportive counselling or through referral to other mental health professionals,” she says.
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