PSYCHIATRIC DISORDERS IN PATIENTS RECEIVING TREATMENT FOR DRUG RESISTANT TUBERCULOSIS REGISTERED UNDER DR-TB CENTRE IN A TERTIARY CARE HOSPITAL

Dr Rupam Kumar Ta, Dr. Pronoy Sen

Abstract


BACKGROUND: The emergence of drug resistant mycobacterium has become a signicant public
health problem creating an obstacle to effective Tuberculosis (TB) control. Psychiatric disorder can either
be induced by treatment regimens or psychosocial factors. Cycloserine administration is frequently reported to be associated
with psychiatric disorders. In this study, we have examined the prevalence and characteristics of psychiatric disorders among
patients receiving treatment for Drug Resistant TB registered in a tertiary care hospital
Aims and Objectives- To evaluate the psychiatric disorders of patients receiving intensive phase treatment of Multi Drug
Resistant Tuberculosis (MDR) and Extensively Drug Resistant Tuberculosis (XDR) as per WHO-UMC Causality Assessment
Scale.
METHODS: 76 patients of MDR and XDR Tuberculosis were admitted in DR-TB (Drug Resistant TB) centre, Burdwan Medical
College and Hospital and the adverse drug reaction prole particularly the psychiatric symptoms of 2nd line drugs were
analysed during the intensive phase for a year after fullling the inclusion and exclusion criteria. Treatment was given as per
guidelines by Revised National TB Control Program PMDT (Programmatic management of drug-resistant TB).
RESULTS: Psychiatric disorders were found in 8(10.5%) patients among whom suicidal attempt 3(3.9%) and depression 3(3.9%)
were the most common followed by paranoia and hallucination in 1 patient each.
CONCLUSIONS: The psychiatric reactions were common in the later phase of the regimen and in patients with BMI ≤18. Hence
vigilant monitoring is required for these types of patients throughout the course of treatment and sputum smear and culture
conversion is very well correlated with clinical and radiological improvement.


Keywords


Psychosis, DR TB, Cycloserine, Depression, Hallucination.

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References


Report WHO/HTM/TB/2006.375 (World Health Organization, Geneva, 2006),Centers for Disease Control and Prevention. Revised definition of extensively drug-resistant tuberculosis. MMWR 2006; 55:1176)

World Health Organization. Multidrug and extensively drug-resistant TB(M/XDR-TB): 2014.

Mahadev B, Kumar P, Agarwal SP, Chauhan LS, Srikantaramu N. Surveillance of drug resistance to anti-tuberculosis drugs in districts of Hoogli in West Bengal and Mayurbhanj in Orissa. [Last cited on 2019 Dec 6]; Indian J Tuberc. 2005 52:5–10. Available from: http://www.imsear.li.mahidol.ac.th/handle/123456789/146942 .

Paramasivan CN, Venkataraman P, Chandrasekaran V, Bhat S, Narayanan PR. Surveillance of drug resistance in tuberculosis in two districts of South India. Int J Tuberc Lung Dis 2002: 6 (6); 479-84

Guidelines on Programmatic Management of Drug Resistant TB (PMDT) in India 2012 https://tbcindia.gov.in/WriteReadData/l892s/8320929355Guidelines%20for%20PMDT%20in%20India%20-%20May%202012.pdf

Hire R, Kale AS, Dakhale GN, Gaikwad N. A prospective, observational study of adverse reactions to drug regimen for multi-drug resistant pulmonary tuberculosis in central India. Mediterr J Hematol Infect Dis. 2014;6(1):e2014061.

Dela AI, Tank NKD, Singh AP, Piparva KG. Adverse drug reactions and treatment outcome analysis of DOTS-plus therapy of MDR-TB patients at district tuberculosis centre: A four year retrospective study. Lung India. 2017 Dec;34(6):522–6.

Nathanson E, Gupta R, Huamani P, Leimane V, Pasechnikov AD, Tupasi TE, et al. Adverse events in the treatment of multidrug-resistant tuberculosis: results from the DOTS-Plus initiative. Int J Tuberc Lung Dis. 2004 Nov;8(11):1382–4.

Irwan Supriyanto, Sak Liung, Suprihatini, Silas Henry Ismanto Psychiatric disorders in patients with

multidrug resistant tuberculosis (MDR-TB) in Sardjito Hospital, Yogyakarta, Indonesia


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