The European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), which took place online from 9-12 July, revealed that people with mental illnesses such as schizophrenia and depression are more likely to contract tuberculosis.Both TB and mental illness are urgent global health issues. They have a high incidence worldwide and often co-exist. Poor mental health has been shown to impact the immune system. However, it is unknown if mental illness is a contributing factor in TB infection or whether an individual is at risk for developing active disease.Sally Hayward and her colleagues from the Institute for Infection and Immunity at St George's University of London, UK in collaboration with Columbia University, New York and the London School of Hygiene and Tropical Medicine examined evidence for a link between mental health and the risk of developing TB. This information will help to inform public and clinical health measures that are aimed at tackling this disease.The authors performed a systematic review on research studies sourced from MEDLINE and PsycINFO medical databases. The inclusion criteria were a publication date within the 1 January 1970-11 May 2020 period and data about the relationship between active TB and mental health.Researchers screened 1,546 studies. This resulted in data from 607,184 people across Asia, South America and Africa over a 50 year period. They examined both depression and psychotic disorders, including schizophrenia.Research done in Asia has provided strong evidence that depression and schizophrenia are linked to an increased chance of developing active TB. Individuals suffering from depression were between 15% and 2.6-times more likely to develop TB than those who didn't have it. Schizophrenia was linked to a 52% increase in risk and a threefold increase in the likelihood of developing TB.An analysis of data from a large study that included 242,952 people in low- and middle-income countries revealed that people with TB are more likely than those without to experience depression.The authors conclude that "our data show that individuals suffering from mental illness, such as schizophrenia and depression, have an increased incidence of TB and therefore represent a high risk population that could be targeted to screen and treat."They also stated that integrated programs for care of mental health and TB were needed. Interventions that address mental illness and their underlying causes may reduce the incidence of TB worldwide.Sally Hayward, a lead author of the study at St George's University of London, stated: "It's obvious that mental health conditions often co-exist with TB, but this study suggests that mental health might play a causal part in increasing TB risks, possibly through its effect on immune system. This highlights the need to work together to reduce the global mental illness burden and improve mental and physical health.###This is a special early release of the European Congress of Clinical Microbiology & Infectious Diseases. (ECCMID 2021). If you use this story, please credit the conference
