The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 6: 937 - 943

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.06.005

Feature Reports：Respiratory Disease

Relationship between mental health status and treatment adherence in MDR/RR-TB patients

  • Jianghuai WANG ,
  • Xiaohe ZHANG ,
  • Wen CHEN
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  • 1.School of Public Health，Sun Yat?sen University，Guangzhou 510080，Guangdong，China2Department of Laboratory Medicine，Nanfang Hospital，Southern Medical University，Guangzhou 510515，Guangdong，China

Received date: 2025-11-13

  Revised date: 2025-12-22

  Accepted date: 2025-12-23

  Online published: 2026-03-26

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Abstract

Objective To investigate the mental health status， including depression， anxiety， and loneliness， of patients with multidrug-resistant/rifampicin-resistant tuberculosis （MDR/RR-TB） and its association with treatment adherence. Methods From October 2024 to July 2025， a total of 900 MDR/RR-TB patients managed in 12 designated tuberculosis hospitals and 60 community health service centers in Guangzhou， Shenzhen， Dongguan， and Zhongshan were enrolled. Psychological status was assessed using the Patient Health Questionnaire-9 （PHQ-9）， Generalized Anxiety Disorder-7 （GAD-7）， and UCLA Loneliness Scale-3 （UCLA-3）. Logistic regression analysis was performed to identify factors influencing treatment adherence. Results Patients were classified into an adherence group （n = 612； 68.00%） and a poor-adherence group （n = 288； 32.00%）. Compared with the adherence group， the poor-adherence group had higher scores on PHQ-9 （12.49 ± 3.85 vs. 5.26 ± 2.16）， GAD-7 （10.23 ± 2.77 vs. 4.88 ± 1.99）， UCLA-3 （6.69 ± 1.17 vs. 4.33 ± 1.06）， and PSQI （10.42 ± 3.17 vs. 6.17 ± 2.38）， and lower scores on SSRS （34.22 ± 5.86 vs. 42.33 ± 6.30）， with all differences being statistically significant. Multivariable logistic regression indicated that higher PHQ-9 （OR = 2.190； 95%CI： 1.699 - 2.823）， GAD-7 （OR = 1.562； 95%CI： 1.266 - 1.927）， UCLA-3 （OR = 2.812； 95%CI： 1.753 - 4.509）， and PSQI scores （OR = 1.267； 95%CI： 1.065 - 1.507）， as well as self-payment as the primary payment method （OR = 15.699； 95%CI： 2.765 - 89.135）， were independent risk factors for poor adherence. Higher monthly household income （OR = 0.183； 95%CI： 0.056 - 0.600）， stronger social support （SSRS： OR = 0.666； 95%CI： 0.602 - 0.736）， and better knowledge of MDR/RR-TB—both general （OR = 0.114； 95%CI： 0.029 - 0.439） and comprehensive （OR = 0.032； 95%CI： 0.007 - 0.154）—were protective factors. Conclusions Depression， anxiety， and loneliness are significantly associated with treatment adherence in MDR/RR-TB patients. Mental health assessment provides a valuable tool for identifying patients at risk of poor adherence and offers evidence for more refined management and targeted interventions.

Key words： multidrug-resistant tuberculosis; rifampicin-resistant tuberculosis; treatment adherence; mental health

Cite this article

Jianghuai WANG , Xiaohe ZHANG , Wen CHEN . Relationship between mental health status and treatment adherence in MDR/RR-TB patients[J]. The Journal of Practical Medicine, 2026 , 42(6) : 937 -943 . DOI: 10.3969/j.issn.1006-5725.2026.06.005

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