Prevalence and Predictors of Depression and Anxiety among Multidrug-Resistant Tuberculosis Patients and Their Household Contacts in Gujarat, India

<title>Abstract</title> Background Mental health comorbidities worsen multidrug-resistant tuberculosis (MDR-TB) outcomes. Patients who have household contacts are also at high risk. We aimed to determine the prevalence, correlates, and predictors of depression and anxiety among MDR-TB-affected families. Methods A cross-sectional analytical study was conducted among 400 MDR-TB patients and 400 household contacts in Gujarat. The validated scales measured depression (PHQ-9), anxiety (HAM-A), perceived stigma (CIASS), and social support (MSPSS). Multivariate logistic regression was used to identify associated factors. Results The prevalence of depression and anxiety symptoms was 150 (37.5%) and 180 (45%) among patients and 80 (20%) and 100 (25%) among contacts, respectively. Stigma (OR 3.2, 95% CI 1.1–5.3), mental illness history (OR 2.1, 95% CI 1.3–3.5), and disease severity (OR 1.8, 95% CI 1.5–2.2) independently predicted greater odds of depression. Similar associations were found for anxiety. Conclusion High mental health comorbidity among MDR-TB patients and interconnectivity with household contacts indicate an urgent need to integrate emotional-physical wellbeing initiatives through decentralized patient-centric care models. Thus, psychosocial support and stigma mitigation should complement conventional services.