Psychiatric--Medical ComorbidityPrevalence of psychosis in tuberculosis patients and their nontuberculosis family contacts in a multidrug treatment-resistant treatment center in Nigeria

ObjectiveThis study aimed at determining the prevalence of psychosis in tuberculosis (TB) patients in comparison to nontuberculosis control and its correlation with disease pattern.MethodOne hundred and fifteen patients with TB and 112 family members visiting the multidrug treatment-resistant treatment center at University College Hospital Ibadan Centre were screened for psychological distress with the General Health Questionnaire (GHQ-12). Presence of a psychotic condition was determined by the Psychosis Screening Questionnaire and the Structured Clinical Interview for DSM-IV Axis I Disorder and was compared with severity of pulmonary TB.ResultsAfter adjusting for age, predictors of high/positive GHQ include the following: duration of TB ≥ 4 years [odds ratio (OR)=4.02, 95% confidence interval (CI)=1.29-11.13], extrapulmonary TB (OR=3.45, 95% CI=1.02-14.11), severe disease extent (OR=5.27, 95% CI=1.05-13.01) and disease category 2 (OR=2.38, 95% CI=1.01-7.99), and predictors of psychosis are as follows: duration of TB ≥ 4 years (OR=3.99, 95% CI=1.51-9.88), extrapulmonary TB (OR=3.88, 95% CI=1.55-9.98), severe disease extent (OR=9.55, 95% CI=2.15-18.05) and disease category 2 (OR=2.86, 95% CI=1.14-7.55).ConclusionIn view of high prevalence of psychological distress and psychosis in TB, care of TB patients should include consultative-liaison psychiatric care.