Cross-sectional Study On Anxiety And Depressive Symptoms In Patients With Endobronchial Tuberculosis

Objectives: Anxiety/depression and tuberculosis are global public health problems.The prevalence of mental illness in tuberculosis patients is reported to be high.However,for Chinese patients with pulmonary tuberculosis,especially with endobronchial tubuerculosis(EBTB).There is no exact data on the prevalence of anxiety and/or depression.This study was designed to determine the prevalence and the associated risk factors of anxiety and depression in patients with EBTB.Methods:A cross-sectional survey of EBTB patients in three hospitals in Liaoning Province was performed using a structured questionnaire.The patients’ depression and anxiety were assessed by the Hospital Anxiety and Depression Scale(HADS),and the patients’ dyspnea was assessed by the m MRC dyspnea score.Results:A total of 336 EBTB patients participated in this study,including 113 males(33.63%)and 223 females(66.37%).The mean age of diagnosis was 34.95±14.53 years.In this study,18.15% of the 336 patients were diagnosed with depressive symptoms according to the HADS scale.Based on univariate analysis,the following factors were associated with an increased risk of depressive symptoms in EBTB patients based on HADS(score≥8): age(51-80 years),monthly income <1500 yuan,married,smoking history(current smoking),history of chronic obstructive pulmonary disease,dust exposure,clinical symptoms≥4 species.Multivariate analysis showed that the following factors were significantly associated with depression: the higher the dyspnea score.In the present study,19.05% of the 336 patients were diagnosed with anxiety symptoms according to the HADS scale.We used a univariate and multivariate model to examine the association between anxiety symptoms and potential risk factors for anxiety diagnosis in 336 patients with EBTB.The results showed that patients with higher m MRC dyspnea scale scores had higher risk of anxiety symptoms,and divorced patients had higher risk of anxiety symptoms.Monthly income <1500 yuan and clinical symptoms≥4 are also risk factors for anxiety symptoms.Multiple regression showed that the increase in dyspnea scores and clinical symptoms≥4 were risk factors for anxiety in EBTB patients.In this study,divorce marital status may increase the risk of anxiety diagnosis in tuberculosis patients,because divorced patients are often isolated and social support is less than married patients,so marital status may be related to anxiety diagnosis.Dyspnea is associated with depression in EBTB patients.Similar to this study results,previous studies have shown that multiple symptoms and dyspnea in patients with chronic respiratory diseases such as COPD and asthma are also risk factors for disease-related depression,thus alleviating the symptoms of patients with chronic airway diseases such as EBTB is also an important means to prevent their potential mental comorbidities.We also found that family,social and social support are protective factors for mental comorbidities in patients with EBTB.High-income EBTB patients are less likely to develop anxiety and depression than low-income patients,suggesting that family and social support play a meaningful role in preventing depression.The study also showed that smoking history was associated with depression in EBTB patients.Smoking is also a risk factor for depression in the general population.Similarly,clinical symptoms≥4 and the increase of dyspnea are risk factors for anxiety in patients with EBTB.Early intervention,especially under bronchoscopy,may be beneficial for symptom relief and dissolution of airway stenosis,which may reduce the risk of anxiety and depression.Conclusions: This study shows that there is a potential for increased prevalence of anxiety or depression in patients with EBTB.Once the diagnosis of EBTB is confirmed,the clinician should pay attention to the patient’s mental state and assess whether the patient has symptoms of anxiety and depression.Screening for depression and anxiety in these patients is critical to identifying those who need further psychological assessment and support.Effective screening can help doctors to identify significant risk factors.The prevalence of anxiety and depression in EBTB patients can be reduced by preventing and intervening risk factors.