The effect of CBT on the mental state of patients with multi-drug resistant tuberculosis

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) is an airborne infectious disease caused by bacteria resistant to isoniazid and rifampicin, the main drugs used in the treatment of TB. Mongolia is one of the 8 countries in worldwide with a high incidence of the MDR-TB. Some factors, such as infectiousness, patients complain, long-term treatment, side effects of antituberculosis drugs, discrimination, unemployment, and lack of finances negatively effect on mental state of tuberculosis patients. We developed a CBT program to solve the mental health problems of MDR-TB patients, and provide psychological support. Aim: To determine effectiveness of the CBT program on mental state of the patient with multi-drug resistant tuberculosis Materials and Methods: We conducted this study using a randomized clinical trial study. The study participated 73 patients, who diagnosed with Rif/MDR-TB in 2020-2021. Patients of case group were provided cognitive behavioral therapy. We used Zung’s self-rating depression scale, Zung self-rating anxiety scale for assessing mental state of casegroup participants before, and after CBT. The reliability of the answers to the scales was calculated by the Cronbach`s α coefÏcient. Results: 52% of total participants were male, and the mean age was 39.38 ± 1.6. Of total participants, 63% had secondary education, 37% were unemployed, and 70% had no history of TB. At the beginning of the CBT program, 29% of total participants were assessed as mild and moderate depression (Cronbach`s alpha=0.805), and 16% were assessed as mild to severe anxiety (Cronbach`s alpha=0.843). Gender was significantly associated with depression (p=0.04) and anxiety (p=0.04). During MDR-TB treatment, the level of depression and anxiety among case group was lower than that of the control group. Conclusion: Depression and anxiety have been reported during treatment of the MDR-TB patients and this mental problem is more common among female patients. CBT has a positive effect on the mental state of the MDR-TB patients.