Infection and Drug Resistance (Jul 2022)
High Incidence of Psychiatric Disorders Associated with Cycloserine Treatment of Multidrug-Resistant Tuberculosis Patients: A Cohort Study in Beijing, China
Abstract
Yu Pang,1 Rongmei Liu,2 Yanhua Song,2 Zizheng Lv,2 Mengqiu Gao,2 Lihui Nie,2 Qiping Ge,2 Xiaoguang Wu2 1Department of Science and Technology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, People’s Republic of China; 2Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, People’s Republic of ChinaCorrespondence: Lihui Nie; Xiaoguang Wu, Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, No. 9, Beiguan Street, Tongzhou District, Beijing, People’s Republic of China, Tel +86-10-8950 9322 ; +86-10-8950 9122, Email [email protected]; [email protected]: Cycloserine (CS) is a group B anti-tuberculosis (TB) drug endorsed by the World Health Organization (WHO) for the treatment of drug-resistant (DR)-TB. Despite CS widespread acceptance and known efficacy, the high potential of drug-associated psychiatric disorders is a major concern to multidrug-resistant (MDR)-TB patients. In this study, we investigated CS-associated psychiatric disorders in a cohort of MDR-TB patients in Beijing, China. Our aim was to determine psychiatric disorder prevalence rates and associated risk factors in this population.Methods: This MDR-TB cohort study was conducted at Beijing Chest Hospital between February 2018 and February 2021. All patients received individualized treatment regimens that included CS at some point during the full treatment course. Patient psychological status was assessed using the Symptom Checklist (SCL-90) questionnaire during the post-treatment follow-up period.Results: Two hundred and thirty-seven MDR-TB patients were included in the final analysis. Overall, psychiatric disorders were recorded in 22 (9.28%) of the 237 patients in our cohort, with severity grades of 1 or 2 observed for the majority (8.44%) of psychiatric adverse events. As compared to results obtained for control group patients who were ≥ 40 years of age, patients who were < 40 years of age (77.3%, 17/22) were more likely to experience psychiatric disorders [adjusted odds ratio (aOR) = 3.060; 95% CI (1.060– 8.828)]. Additionally, patients with body mass index (BMI)s of < 18.5 kg/m2 [aOR = 3.824; 95% CI (1.502– 9.739)] had significantly higher odds of being afflicted with psychiatric disorders as compared with patients with BMIs that were ≥ 18.5 kg/m2.Conclusion: Our results demonstrated that approximately one-tenth of Chinese MDR-TB patients experienced psychiatric disorders during CS treatment, with the majority of adverse events of moderate severity. In addition, low BMI and age < 40 years were identified as independent risk factors for psychiatric disorders in MDR-TB patients receiving CS therapy.Keywords: cycloserine, multidrug-resistant tuberculosis, incidence, risk factor, psychiatric disorder
