Factors Associated with Mental Health Problems Among Tuberculosis Patients Attending Tertiary Care Hospitals in the Bangkok Metropolitan Region, Thailand: A Hospital-Based Survey.

Abstract

Background: Little is known about mental health among tuberculosis (TB) patients in Thailand. This study aimed to identify factors associated with mental health problems in TB patients in urban Thailand. Methods: This cross-sectional study collected data from 210 TB patients receiving treatment at two tertiary care hospitals in the Bangkok Metropolitan Region of Thailand using consecutive sampling. The General Health Questionnaire (GHQ-12) and the Patient Health Questionnaire (PHQ-9) were used to assess mental health problems and probable depression, respectively. Results: Among TB patients, 34.3% had mental health problems (95% CI: 27.8-40.8), and 23.8% had depression (95% CI: 18.0-29.6). The final model from logistic regression with forward selection identified factors significantly associated with mental health problems, including high family support (OR = 0.45; 95% CI: 0.24-0.83) and perceived stigma: low (OR = 2.77; 95% CI: 1.16-6.60), moderate (OR = 3.56; 95% CI: 1.66-7.65), and high (OR = 3.56; 95% CI: 1.31-9.67) versus no stigma. Depression was associated with income ≥10,000 baht (OR = 0.43; 95% CI: 0.21-0.87), alcohol consumption (OR = 2.90; 95% CI: 1.27-6.64), and high social support from healthcare providers (OR = 0.44; 95% CI: 0.22-0.87). Conclusion: This study highlights the need to integrate mental health services into the TB care program to address the TB challenge in Thailand. Policies such as routine mental health screening and psychological counseling alongside treatment, as well as expanded social support and stigma reduction interventions, should be implemented to reduce the risk of mental health issues, particularly depression, and improve treatment outcomes among Thai TB patients.