Psychological perspectives and correlation of various psychological scales in tuberculosis- an observational study

Tuberculosis (TB) remains a significant global health concern, affecting millions of individuals annually. While its physical manifestations and treatment protocols have been extensively studied, the psychological dimensions of TB have garnered increasing attention in recent years. This cross-sectional observational study explored the psychological aspects of TB among TB patients undergoing treatment in a tertiary care hospital.

This was a cross-sectional clinic-based descriptive study conducted on 100 patients of pulmonary TB (PTB) and 60 patients of extrapulmonary TB (EPTB). Psychological distress was assessed using General Health Questionnaire-12 (GHQ-12), and the correlations of other psychological scales, like WHO Quality of Life Brief-26 (WHOQOL-Bref-26), Patient Distress Thermometer (PDT), Depression Anxiety Stress Scale (DASS) and Coping Strategy Checklist (CSCL). Patients with a GHQ-12 score of ≥3 were considered to be experiencing psychological distress and subsequently referred to a consultant psychiatrist for a more detailed evaluation and management.

Findings revealed a high prevalence of psychological distress (GHQ-12 ≥ 3) among TB patients, 58 % of PTB patients and 60 % of EPTB patients experienced psychological distress after screening with GHQ-12; 40 % of all the PTB and EPTB patients were diagnosed with a psychiatric illness, after evaluation by the psychiatrist. Patients of PTB and EPTB almost had similar scores on GHQ-12, WHOQOL-Bref-26, PDT, CSCL, and DASS. These scores did not differ significantly between PTB and EPTB patients. The scores on all these scales (WHOQOL-Bref-26, PDT, CSCL, and DASS) in the patients of PTB and EPTB who were experiencing psychological distress (GHQ ≥3) were significantly poorer than those without psychological distress (GHQ <3).

The study sheds light on the psychological dimensions of TB. Psychological distress and psychiatric illness leading to poorer quality of life were present in a significant number of TB patients. Therefore, mental health evaluation should be incorporated into the routine management of these patients, and a brief screening tool like GHQ-12 can be of immense help.