Predictors of Major Depression in Recently Diagnosed Patients with HIV/AIDS in South Africa (original) (raw)
Related papers
Depression and trauma are common among women living with HIV. This is the first study to track the longitudinal course of depression and examine the relationship between depression and trauma over time among women in South Africa. HIVinfected and uninfected women (N = 148) were assessed at baseline and one year later. Results of a path analysis show the multi-directional and entwined influence of early life stress, other life-threatening traumas across the lifespan, depression and PTSD over the course of HIV. We also observed higher rates of depressive symptomatology and more persistent cases among infected women compared to uninfected women, as well as a more consistent and enduring relationship between childhood trauma and depression among women living with HIV. The present study is unique in documenting the course of untreated depression and PTSD in women with and without HIV infection with a high prevalence of early childhood trauma.
Cross-sectional studies on psychological responses associated with an HIV diagnosis are replete, but a paucity of research exists to evaluate the changes and stability of these responses, particularly among black African women. One hundred and five HIV-positive black and coloured women were studied as they reported for follow-up health management at the outpatient clinic for infectious diseases at Tygerberg Hospital in Cape Town, South Africa. They were assessed at baseline and 51 returned for a follow-up interview six months later. Assessments involved use of the Mini-International Neuropsychiatric Interview (MINI), the Carver Brief COPE, and the Sheehan Disability Scale. Negative life events and risk behaviours were also evaluated. Fifty-nine women (56.2%) were diagnosed with at least one psychiatric disorder on the MINI at baseline. The most frequent diagnosis was major depression (38.1%), followed by dysthymic disorder (22.9%). A diagnosis of HIV or AIDS exacerbated the premorbid state of 19% of the women who reported a past history of depression. Twelve women (11.4%) were at risk for suicide, while 19% met criteria for a clinical diagnosis of post-traumatic stress disorder (PTSD) and 6.7% met the diagnosis of generalised anxiety disorders. At follow-up, 26 (51%) were diagnosed with at least a psychiatric disorder. Eleven (21.6%) met the criteria for major depression, while eight (15.7%) had a past history of depression. The number of women with PTSD increased from 19% of the total sample at baseline to 29.4% of those interviewed at follow-up. Conversely, the number with dysthymia dramatically decreased from 24 women (22.9%) at baseline to just one woman at follow-up. The number displaying suicidality also decreased from 12 at baseline to four at follow-up. At both baseline and follow-up, the number and impact of negative life events significantly increased the likelihood of major depression persisting or recurring, but this association was not found for PTSD. These findings indicate that, over time, there is variability in psychiatric morbidity among coloured and black African women living with HIV and that a high number of negative life events may increase the likelihood of persistent major depression in these women.
Journal of Family Medicine and Primary Care, 2017
Introduction: Depression, being the most common neuropsychiatric complication of HIV, is also associated with increased health-care utilization, decreased quality of life (QOL), and poor adherence to antiretroviral therapy (ART). Depression is a multidimensional disorder affected by a variety of biological, psychological, and social determinants and this relation becomes more complicated in HIV patients. The current study therefore aimed to investigate the sociodemographic and clinical determinants of depression and assess difference in the QOL of HIV patients not having depression and those suffering from depression. Materials and Methods: A cross-sectional study was conducted at an ART center in a tertiary care hospital in HIV/AIDS patients of 18 years of age. Sociodemographic and clinical characteristics were studied, depression anxiety and stress scale-21 was used to assess depression, and QOL assessment was done using WHOQOL-HIV BREF questionnaire. Results and Conclusions: Out of 754 study subjects, 377, i.e., 50% suffered from depression and nearly 75.9% of them were in the age group of 25-44 years. The prevalence of depression was higher in females, illiterates, and unemployed HIV patients as compared to males, literates, and employed subjects, respectively. HIV patients who were depressed had significantly lower QOL than the subjects not suffering from depression, more so in the environment and social relationships domains.
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2014
Understanding the experience of depression in people living with HIV/AIDS (PLWH) could aid in the detection and treatment of the disorder. Yet, there is limited knowledge of the subjective experience of depression amongst PLWH in low-and middle-income countries despite high rates of this disorder in this population. In the current study, semistructured interviews were conducted with depressed adults living with HIV attending a primary infectious disease clinic in South Africa. Interview transcripts were thematically analyzed. The construct of depression was consistent with DSM-IV criteria; however, the symptom presentation was distinctive. Somatic symptoms were most prominent in participants' initial presentations because participants perceived them as medically relevant. Affective, cognitive, and behavioral symptoms were not readily reported as participants did not perceive these symptoms as pertinent to their medical treatment. We identified several idioms of distress that could assist in screening for depression in this population. A valid, contextually developed screener for depression in PLWH awaits further investigation. Such a measure could play a key role in formulating a logistically feasible method of detection and treatment for depression in this population.
Understanding the experience of depression in people living with HIV/AIDS (PLWH) could aid in the detection and treatment of the disorder. Yet, there is limited knowledge of the subjective experience of depression amongst PLWH in low-and middle-income countries despite high rates of this disorder in this population. In the current study, semistructured interviews were conducted with depressed adults living with HIV attending a primary infectious disease clinic in South Africa. Interview transcripts were thematically analyzed. The construct of depression was consistent with DSM-IV criteria; however, the symptom presentation was distinctive. Somatic symptoms were most prominent in participants' initial presentations because participants perceived them as medically relevant. Affective, cognitive, and behavioral symptoms were not readily reported as participants did not perceive these symptoms as pertinent to their medical treatment. We identified several idioms of distress that could assist in screening for depression in this population. A valid, contextually developed screener for depression in PLWH awaits further investigation. Such a measure could play a key role in formulating a logistically feasible method of detection and treatment for depression in this population.
Depression in women living with HIV: clinical and psychosocial correlates
Archives of Women's Mental Health, 2010
The number of Brazilian women living with HIV has increased significantly in past years, rendering studies of their particular care demands including psychiatric issues. This study measures the prevalence of major depression, using the Structured Clinical Interview for DSM-IV Axis I Disorders, in a sample of 120 women living with HIV in treatment at a reference centre in São Paulo. Socio-demographic variables, HIV-related clinical and laboratory data, including CD4+ cell counts and HIV plasma viral loads, as well as psychosocial features (intimate relationships, disclosure of HIV serostatus, partner's serostatus and patient's emotional and financial support) were investigated as factors potentially associated with depression. The prevalence of major depression at the time of evaluation was 25.8% (95% CI 18.2-33.4%). Clinical status (p=0.002), lack of emotional support (p= 0.02), use of antidepressants (p=0.028) and length of time since HIV diagnosis (p=0.05) were associated with major depression in univariate analysis. In multivariate multipleregression model, HIV clinical status, lack of emotional support and higher plasma viral loads were associated with depression. Sixty per cent of the women have a major depression diagnosis during lifetime. We conclude that major depression is highly prevalent among women living with HIV, but it is still underdiagnosed and undertreated.
Depression and social functioning among HIV-infected and uninfected persons in South Africa
AIDS Care, 2014
Depression and other health problems are common co-morbidities among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). The aim of this study was to investigate depression, health status, and substance use in relation to HIVinfected and uninfected individuals in South Africa. Using a cross-sectional case-control design, we compared depression, physical health, mental health, problem alcohol use, and tobacco use in a sample of HIV infected (N=143) and HIV uninfected (N=199) respondents who had known their HIV status for two months. We found that depression was higher and physical health and mental health were lower in HIV positive than HIV negative individuals. Poor physical health also moderated the effect of HIV infection on depression; HIV positive individuals were significantly more depressed than HIV negative controls, but only when general physical health was also poor. We did not find an association between alcohol or tobacco use and HIV status. These results suggest the importance of incorporating the management of psychological health in the treatment of HIV.
Prevalence and associated risk factors for major depressive disorder among women living with HIV
THE INTERNATIONAL JOURNAL OF HUMANITIES & SOCIAL STUDIES, 2018
Major depressive disorder is common among women living with HIV than their counterparts. The illness is associated with deleterious outcomes including antiretroviral therapy resistance, increased opportunistic infections, mortality, and increased socioeconomic burden to the individual, family, and society. Hence, investigating the prevalence of the illness and its risk factors among women living with HIV is important for further interventions. A health-facility based cross -sectional study was conducted at Machakos Level 5 and Kangundo Level 4 Hospitals, Kenya. Data was collected using a structured standardized scale and a researcher-generated questionnaire. Convenience sampling was used to select 313 participants. The prevalence of major depressive disorder was 35.5%. Inferential analysis revealed that attending religious service of some sort, financial constraint, alcohol use, and perception of health status as fair were risk factors for major depressive disorder (p’s/0.051. Ministry of Health should routinely screen all women living with HIV for depressive symptoms and intervene early to avert further complications. Keywords: Prevalence, HIV, depression, risk factors