title: Common mental disorders associated with tuberculosis: a matched case-control study.
abstract: BACKGROUND
  Despite the availability of treatment and a vaccine, tuberculosis continues to be a public health problem worldwide. Mental disorders might contribute to the burden of the disease.
  
  
  OBJECTIVE
  The objective of this study was to investigate the association between common mental disorders and tuberculosis.
  
  
  METHODS
  A matched case-control study was conducted. The study population included symptomatic respiratory patients who attended three referral hospitals and six community clinics in the city of Salvador, Brazil. A doctor's diagnosis defined potential cases and controls. Cases were newly diagnosed tuberculosis cases, and controls were symptomatic respiratory patients for whom tuberculosis was excluded as a diagnosis by the attending physician. Cases and controls were ascertained in the same clinic. Data collection occurred between August 2008 and April 2010. The study instruments included a structured interview, a self-reporting questionnaire for the identification of common mental disorders, and a questionnaire for alcoholism. An univariate analysis included descriptive procedures (with chi-square statistics), and a multivariate analysis used conditional logistic regression.
  
  
  RESULTS
  The mean age of the cases was 38 years, and 61% of the cases were males. After adjusting for potential confounders, the odds of tuberculosis were significantly higher in patients diagnosed with a common mental disorder (OR: 1.34; 95% CI 1.05-1.70).
  
  
  CONCLUSIONS
  There appears to be a positive and independent association between common mental disorders and tuberculosis; further epidemiological studies are required to increase our understanding of the possible biological and social mechanisms responsible for this association. Independent of the direction of the association, this finding has implications for the provision of care for mental disorders and for tuberculosis.
authors.affiliation: Departamento de Saúde Coletiva, Institute of Collective Health of the Federal University of Bahia, Bahia, Brazil.
authors.forename: Gleide Santos
authors.initials: GS
authors.lastname: de Araújo
authors.affiliation: Departamento de Saúde Coletiva, Institute of Collective Health of the Federal University of Bahia, Bahia, Brazil.
authors.forename: Susan Martins
authors.initials: SM
authors.lastname: Pereira
authors.affiliation: Departamento de Saúde Coletiva, Institute of Collective Health of the Federal University of Bahia, Bahia, Brazil.
authors.forename: Darci Neves
authors.initials: DN
authors.lastname: dos Santos
authors.affiliation: Departamento de Medicina Interna, School of Medicine and Public Health, Bahia, Brazil.
authors.forename: Jamocyr Moura
authors.initials: JM
authors.lastname: Marinho
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Laura Cunha
authors.initials: LC
authors.lastname: Rodrigues
authors.affiliation: Departamento de Saúde Coletiva, Institute of Collective Health of the Federal University of Bahia, Bahia, Brazil.
authors.forename: Mauricio Lima
authors.initials: ML
authors.lastname: Barreto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult