Depressive Symptoms in Pediatric Tuberculosis: A Retrospective Two-Time-Point Observational Study

Tuberculosis (TB) in children is associated not only with infectious burden but also with potential psychological distress, which remains insufficiently explored. The aim of this study was to evaluate the pattern and evolution of depressive symptoms in pediatric TB patients during treatment using a structured screening approach.

We conducted a retrospective observational study including 190 pediatric patients aged 7-18 years diagnosed with tuberculosis between 2019 and 2021. Depressive symptoms were assessed at two time points, namely at diagnosis (T0) and at first follow-up (T1), using a 10-item structured clinical screening tool routinely applied in practice. A threshold of ≥50% affirmative responses was used to identify patients with suspected depressive symptoms. The Children's Depression Inventory (CDI) was administered to patients with positive screening results, according to standard clinical protocols. Descriptive and comparative analyses were performed to evaluate changes over time.

A high proportion of patients screened positive for depressive symptoms at baseline (T0). At follow-up (T1), a reduction in the proportion of patients with suspected depressive symptoms was observed; however, a substantial number of patients continued to report symptoms suggestive of emotional distress. Most symptom changes between T0 and T1 were not statistically significant, with the exception of decreased appetite, which showed a modest improvement. The overall pattern suggests persistence of symptoms in a subset of patients over time.

These findings suggest that symptoms indicative of psychological distress are common among pediatric TB patients and may persist during treatment. However, given the use of a non-validated screening tool and the retrospective design, the results should be interpreted with caution. The study highlights the potential value of systematic psychological assessment in this population and supports the need for further research using validated instruments.