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Associations between mental illness, TB risk and migrant status
S E Hayward1,2, K L Kristensen3,4, A Deal1,2
1Institute for Infection and Immunity, School of Health and Medical Sciences, City St George's, University of London, London, UK.
IJTLD Open
|December 16, 2024
Summary
Individuals with mental disorders, especially those with substance use or psychosis, face a significantly higher risk of tuberculosis (TB). This highlights the need for integrated mental health care and targeted TB screening for this vulnerable population.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Tuberculosis (TB) and mental illnesses are significant public health concerns, frequently co-occurring.
- Migrants in high-income nations are disproportionately affected by both conditions.
- Understanding the interplay between mental health and TB risk is crucial for effective public health strategies.
Purpose of the Study:
- To investigate the influence of mental illness on tuberculosis risk.
- To examine how migration status affects the relationship between mental illness and TB.
- To identify specific mental disorders associated with elevated TB risk.
Main Methods:
- A nationwide prospective cohort study was conducted in Denmark from 1994 to 2015.
- The study included a large cohort of migrants and matched Danish-born individuals.
- Cox regression models were employed to analyze the association between mental disorders and TB risk, adjusting for relevant covariates.
Main Results:
- Individuals with mental disorders exhibited a substantially higher incidence of TB compared to those without.
- The risk of TB was significantly elevated in Danish-born individuals with mental disorders (HR 15.51) compared to migrants (HR 1.37).
- Specific mental disorders, including substance use disorders (HR 5.49) and psychosis (HR 4.19), were strongly associated with increased TB risk.
Conclusions:
- People with mental illnesses, particularly those with psychotic and substance use disorders, represent a high-risk group for TB.
- Targeted TB screening and treatment strategies are essential for individuals with mental disorders.
- Integrating comprehensive mental health care into TB programs is recommended for a holistic approach to patient well-being.
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