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Journal of Analytical Research in Clinical Medicine
   eISSN: 2345-4970  
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Article History
Submitted: 16 Jun 2017
Accepted: 26 Jul 2017
First published online: 09 Aug 2017

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J Anal Res Clin Med. 2017;5(3):91-96 doi: 10.15171/jarcm.2017.018

Psychiatric disorders in patients with multidrug resistant tuberculosis (MDR-TB) in Sardjito Hospital, Yogyakarta, Indonesia  

Original Article

Irwan Supriyanto 1 * , Sak Liung 1, Suprihatini Suprihatini 1, Silas Henry Ismanto 2

1 Department of Psychiatry, School of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
2 Department of Psychiatry, School of Medicine, Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia



Abstract

Introduction: Tuberculosis has become a chronic debilitating disease in developing countries, particularly after the emergence of multidrug resistant tuberculosis (MDR-TB). Second line treatments for the disease which were subsequently developed were associated with psychiatric disorders among patients. Psychiatric disorder can either be induced by treatment regiments or psychosocial factors. Cycloserine administration is frequently reported to be associated with psychiatric disorders. In this study, we examined the prevalence and characteristics of psychiatric disorders among MDR-TB patients in Sardjito Hospital, Yogyakarta, Indonesia. Methods: In this descriptive study, we studied medical records of MDR-TB patients admitted for MDR-TB treatments to Sardjito Hospital from January 2014 to July 2016 and screened for psychiatric disorders. Results: We found that 32.8% of the patients had psychiatric disorders, some of which had multiple psychiatric diagnoses (14.1%). The diagnoses were medication induced delirium, substance/medication induced psychotic disorder, substance/medication use depressive disorder, depressive type schizoaffective disorder, bipolar I disorder current episode severe manic with psychotic features, mild depression, moderate depression, major depression without psychotic features, major depression with psychotic features, adjustment disorders with mixed anxiety and depressed mood, adjustment disorder with anxiety, acute stress disorder, and insomnia. Psychiatric disorders were significantly associated with cycloserine dose and sex. Psychotic symptoms were significantly associated with sex and level of education. Conclusion: The presence of psychiatric disorders might disturb MDR-TB treatment resulting in poor outcomes. Precaution and prompt managements are required for psychiatric disorders in patients receiving MDR-TB treatment regiments.







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