Table 3.
Findings of included studies reporting an association between mental disorders and tuberculosis treatment outcomes
| Study | Mental disorder |
TB treatment outcome |
Definition of TB treatment outcome |
Time of outcome assessment |
Adjustment for confoundersa |
Findings |
|---|---|---|---|---|---|---|
| Ambaw | Depression | Success | Cure or treatment course completion | 6 months | Age, Sex, SES | Adjusted RR 0.95 (0.91-1.00) |
| Tola | Psychological distress | Success | Cure or treatment course completion | 6 months | Age, Sex, SES | Adjusted OR 2.87 (1.05-7.81) |
| Scuffell | Mental disorder | Poor | Failure, loss to follow-up, or death | Not applicable | None | Unadjusted OR 1.59 (0.26-17.6) |
| Ugarte-Gil | Depression | Poor | Death or loss to follow-up | 6 months | Age, Sex, SES | Adjusted HR 3.46 (1.48-8.08) |
| Ambaw | Depression | Loss to follow-up | Patient on treatment for at least four weeks and whose treatment was interrupted for eight or more consecutive weeks | 6 months | Age, Sex, SES | Adjusted RR 9.09 (6.72-12.30) |
| Franke | Mental disorder | Loss to follow-up | Patient missed ≥ 30 consecutive days of treatment, prior to physician-approved treatment completion or a physician suspended medications for a patient who was repeatedly nonadherent even after having undergone adherence counseling. | Not applicable | Age, Sex, SES | Unadjusted HR 0.96 (0.50-1.83) |
| Ambaw | Depression | Death | Death of patient (due to any cause) within six months of starting treatment | 6 months | Age, Sex, SES | Adjusted RR 2.99 (1.54-5.78) |
| Theron | Psychological distress | Death | Not specified | 6 months | Not reported | Unadjusted OR for continuous exposure 1.056 (1.035-1.082) |
| Theron | Psychological distress | Non-adherence | Patients who were noted to have missed at a scheduled DOTS visit as recorded on the patient's DOTS clinic card | 2 months | Not specified. Adjusted for site-baseline morbidity, and other clinical and socioeconomic differences. | Adjusted OR 2.29 (1.03-5.10) |
| Govender | Depression | Non-adherence | Patients still taking their anti-TB treatment at the end of the intensive phase. | End of intensive phase | None | Reported mean depression score of 7.14 (6.28-8.00) non-adherence versus 2.55 (1.88-3.22) adherence |
| Naidoo | Psychological distress | Non-adherence | Adherence assessed with the following question: "In your tuberculosis treatment in the past 3-4 weeks how many percent of your anti-tuberculosis medication did you take?" Adherence defined as having taken less than 90% of the anti-TB drugs. | During intensive phase of DOTS programme | Age, Sex, SES | Adjusted OR 0.94 (0.73-1.22) |
| Peltzer | Post-traumatic stress disorder | Non-adherence | Visual Analogue Scale to answer “In past 3–4 weeks how many percent were you taking your anti-tuberculosis medication?”. Non-adherence defined as having taken less than 90% of their anti-TB medication. | Within 1 month of treatment | None | Unadjusted OR 1.00 (0.86-1.17) |
| Yan | Severe depressive symptoms | Non-adherence | 8-item Morisky Medication Adherence Scale score less than 6 being low adherence, 6 to less than 8 being medium adherence, and 8 and higher being high adherence | No information | Age, Sex, SES | Compared to high adherence, adjusted OR 3.67 (2.04-6.61) for low TB treatment adherence |
a
SES = socioeconomic status