The Invisible Toll: Unveiling the Prevalence and Predictors of Depression and Anxiety Among Pulmonary Tuberculosis (TB) Patients and Their Households in Gujarat, India

Background: Tuberculosis (TB) imposes a substantial physical and psychological burden on patients and their families. This study aimed to investigate the prevalence and predictors of depression and anxiety among pulmonary TB patients and their household contacts in Jamnagar, Gujarat, India. Materials and methods: A cross-sectional study was conducted at TB units (TUs) in Jamnagar, Gujarat. Trained research assistants interviewed 272 pulmonary TB patients and 544 household contacts using structured questionnaires. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Sociodemographic, clinical, and psychosocial factors (stigma and social support) were evaluated. Logistic regression analyses were performed to identify predictors of depression and anxiety. A p-value of < 0.05 was considered statistically significant for all analyses in this study. Results: Out of 272 TB patients and 544 household contacts, the prevalence of depression was 98 (36.0%) and 135 (24.8%) (p=0.001). Anxiety was present in 85 (31.3%) of TB patients and 112 (20.6%) of household contacts (p<0.001). For TB patients, low household income (AOR=2.1, 95% CI: 1.9-4.3), low social support (AOR=0.84, 95% CI: 0.6-0.9), and high perceived stigma (AOR=2.3, 95% CI: 1.3-4.5) were independently associated with depression. Among household contacts, similar factors were identified, including low household income (AOR=1.7, 95% CI: 1.6-2.9), low social support (AOR=0.88, 95% CI: 0.6-0.9), and high perceived stigma (AOR=1.80, 95% CI: 1.1-2.3). Conclusion: Depression and anxiety are highly prevalent among pulmonary TB patients and their household contacts in Gujarat, India. Low socioeconomic status, lack of social support, and TB-related stigma emerged as significant predictors of these mental health conditions, underscoring the need for integrated, multidisciplinary interventions to address the psychological impact of TB on patients and their families.