Source: Annual Congress 2001 - Drug resistant TB

Abstract

Thirty seven MDR TB patients on treatment under DOTS Plus program have been subjected to a pathopsychological analysis. In 72.9% a premorbid aggravating condition was identified, 40.5% of whom were alcoholics, and 5.4% had a drug addiction with at least 3 years in remission. 81% of the patients developed psychiatric disorders during treatment: pronounced astenias in 57% (emotional lability, mood swings, anxiety, sleep disorders), depression in 13.5%, acute psychoses in 10.8% (2 cases of delirium, 1 case of hallucinatory-paranoid syndrome against the background of anxious-depressive condition with Kandinsky-Cleramboux elements, and 1 case of paranoid syndrome with persecution mania and affective content). To correct the astenic disorders we used benzodiazepines, glutamic acid and B-vitamins. To treat depression, tranquillizers and tricyclic antidepressants were administered. In cases of psychosis we either discontinued or reduced the dose of cycloserin, applied disintoxication methods and tranquillizers; in more severe cases, neuroleptics with selective action (haloperidol) were prescribed. There was one case of relapsed psychosis (2.7%) which called for a continuous administration of haloperidol. In most cases a timely psychothropic correction allows the continuation of adequate TB chemotherapy against the background of concurrent psychiatric disorders.

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O. A. Yarosh, O. S. Kostornoy, A. V. Barnashov, S. P. Mishustin, E. G. Andreev, A. D. Pasechnikov, A. A. Trusov, E. V. Goncharova, S. Perkins, V. Y. Semke (Tomsk, Russia; New York, United States Of America; London, United Kingdom). Psychiatric disorders in MDR TB patients on the treatment regimens under DOTS-plus programme in Tomsk oblast penitentiary system. Eur Respir J 2001; 16: Suppl. 31, 3464

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