Tuberculosis - I.T. Pyatnochka 2005

Pulmonary tuberculosis combined with other diseases and pregnancy
Neuropsychiatric disorders in tuberculosis

Tuberculosis can be accompanied by neuropsychiatric disorders, the onset of which stems from various causes. Broadly speaking, they can be divided into: 1) psychological reactions triggered by the tuberculosis Diagnosis; 2) neuropsychiatric disorders caused by tuberculosis intoxication; and 3) neuropsychiatric reactions resulting from anti-tuberculosis drug Treatment.

Psychogenic reactions typically manifest as depression, driven by fear and anxiety regarding one's own health and the well-being of loved ones. These reactions are often exacerbated by The behavior of medical staff, particularly when a diagnosis is communicated abruptly and insensitively.

Paradoxical reactions have also been documented in tuberculosis patients, characterized by anxiety and distress over the prospect of a "superinfection." This can manifest as behavioral disturbances, defiance, lack of discipline, and refusal to undergo treatment or remain hospitalized.

Neuropsychiatric disorders directly caused by the tuberculosis process itself may be linked to either systemic intoxication or localized organ damage. This is most vividly observed in Miliary tuberculosis, Tuberculous meningitis, Subacute Disseminated Pulmonary Tuberculosis, and chronic fibro-cavernous pulmonary tuberculosis.

Psychiatric complications during antimycobacterial therapy are relatively rare. Borderline neuropsychiatric disorders, specifically asthenic syndrome and affective reactions, are observed more frequently. Severe forms of tuberculosis, albeit quite rarely, can be accompanied by psychosis. In such cases, symptoms may include altered states of consciousness, amnestic syndrome, hallucinations, and delusions.

The Prevention and management of neuropsychiatric disorders in tuberculosis patients depend on The Nature of the underlying disease. Effective antimycobacterial therapy rapidly eliminates intoxication and its damaging effects on the central and autonomic nervous systems. Psychotherapy plays a vital role. Physicians must be able to explain the symptoms of tuberculosis adeptly and reassuringly convince the patient that modern treatment Methods will lead to a full recovery. To achieve this, however, the physician must first earn the patient's trust.