Occurrence of anxiety and depression among homeless individuals with pulmonary tuberculosis

Tuberculosis and mental health issues are global health concern. Homelessness is a serious public health issue. There has been a relationship established between homelessness and mental illnesses. In this study, we see the mental health problems in homeless people with Pulmonary Tuberculosis (PTB).

PTB patients who were homeless living in shelter in Delhi, aged 22 years and above, were asked questions related to Anxiety and Depression. The tools used were PHQ-2 (patient health questionnaire), GAD-7 (general anxiety disorder), and CESD-R-10 (centre for epidemiologic studies depression scale revised).

Out of 47 PTB patients screened, 4.2% (2, n = 47) had Minimal Anxiety, 51% (24, n = 47) had Mild Anxiety, 40.4% (19, n = 47) had Moderate Anxiety, 4.2% (2, n = 47) had Severe Anxiety, and 95.7% (45/47) had Depression. 78% (37, n = 47) were symptomatic for TB at the time of screening before being diagnosed with PTB and 22% (10, n = 47) were asymptomatic for PTB at the time of screening before being diagnosed with PTB. 34% (16/47) had history of PTB and 66% (31/47) had no history of PTB.

There is a strong occurrence of Anxiety and Depression in homeless people with PTB. Patients who were symptomatic without history of PTB is more than half (53.19%). 22% of the people were asymptomatic at the time of screening, so it can be assumed that people were unaware that they have been suffering from PTB. In India, there is need to assess mental health issues among homeless TB patients on larger sample size. As the burden of mental illnesses is increasing and homeless population remains an unnoticed population.