A Comparison of Clinical Features of Depressed and Non-Depressed People Living with HIV/AIDS, in Nigeria, West Africa (original) (raw)
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Family Medicine & Primary Care Review, 2021
Background. Mental health disorders have received little attention amongst people living with HIV/AIDS (PLWHA). Depression is the most common psychiatric consequence of HIV/AIDS diagnosis. Its prevalence is higher among PLWHA than the general population. Objectives. To determine the prevalence of depression, to identify its associated factors and, lastly, to determine its association with treatment outcome measures among PLWHA on antiretroviral therapy (ART) aged ≥ 18 years receiving care at the HIV clinic of General Hospital, Lagos. Material and methods. A cross-sectional study was conducted using the systematic random sampling method to select participants over a period of 14 weeks. An interviewer-administered questionnaire was designed to capture socio-demographic, behavioural, psychosocial, HIV and health-related information, as well as the clinical data of the participants. The Patient Health Questionnaire (PHQ-9) was used to assess depression. The relationships between depression and other participants' characteristics were tested with Pearson's chi-squared (χ 2) test. Logistic regression analysis was used to minimise confounding, and the level of statistical significance was set as a p-value of ≤ 0.05. Results. The total of 279 respondents, with a mean age of 43.1 ± 10.3 years, were predominantly females (67.7%). The prevalence of depression among the participants was 24%. Factors such as occupation (p = 0.041; 95% CI, 0.43 to 3.63), alcohol intake (p = 0.036; 95% CI, 0.62 to 3.82), cohabitation (p = 0.025; 95% CI, 1.43 to 3.82), stigmatisation (p = 0.008; 95% CI, 0.92 to 3.70) and personal history of depression (p < 0.001; 95% CI: 1.75 to 6.38) showed statistically significant relationships with depression. Conclusions. The burden of depression is high among PLWHA. Identifying and unravelling factors associated with depression among PLWHA and advocacy against stigmatisation will play a significant role in reducing this burden.
Clinical features of depression in Uganda.pdf
Objective: Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 3 times higher than the general population. It's still questionable whether HIV related depression is clinically different from depression in HIV-negative populations, a fact that could have treatment implications.This study compared the clinical features of major depression between HIV-Positive and HIV-negative patients with a view to intervention strategies. Method: A comparative, descriptive, cross-sectional study was carried out on 64 HIV-Positive depressed patients and 66 HIV-negative depressed patients in Butabika and Mulago hospitals. They were compared along the parameters of clinical features of depression, physical examination and laboratory findings. Pair wise comparisons, logistic regression and Multivariate analysis were done for the two groups on a number of variables. Results: Compared to HIV-Negative patients, HIV-Positive patients were more likely to be widowed ; older (≥ 30years), less likely to have a family member with a mental illness; a later onset of depressive illness (≥30years); more likely to have a medical illness and taking medication before onset of depressive, symptomatically compared to HIV-Negative patients, HIV-Positive patients were more critical of themselves ; had significantly more problems making decisions ; had poorer sleep; felt more easily tired; more appetite changes; more cognitive impairment. Low CD4 counts were not significantly associated with depression, but HIV related depression was more likely to occur in stages II and III illness. Conclusion: These findings show that the clinical and associated features of depression differ between HIV-Positive and HIV-Negative patients, thus requiring different management approaches and further studies related to HIV-related depression.
Journal of Public Health in Africa, 2014
Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART) by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria.
African Journal of Psychiatry, 2010
Objective: Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 3 times higher than the general population. It's still questionable whether HIV related depression is clinically different from depression in HIV-negative populations, a fact that could have treatment implications.This study compared the clinical features of major depression between HIV-Positive and HIV-negative patients with a view to intervention strategies. Method: A comparative, descriptive, cross-sectional study was carried out on 64 HIV-Positive depressed patients and 66 HIV-negative depressed patients in Butabika and Mulago hospitals. They were compared along the parameters of clinical features of depression, physical examination and laboratory findings. Pair wise comparisons, logistic regression and Multivariate analysis were done for the two groups on a number of variables. Results: Compared to HIV-Negative patients, HIV-Positive patients were more likely to be widowed ; older (≥ 30years), less likely to have a family member with a mental illness; a later onset of depressive illness (≥30years); more likely to have a medical illness and taking medication before onset of depressive, symptomatically compared to HIV-Negative patients, HIV-Positive patients were more critical of themselves ; had significantly more problems making decisions ; had poorer sleep; felt more easily tired; more appetite changes; more cognitive impairment. Low CD4 counts were not significantly associated with depression, but HIV related depression was more likely to occur in stages II and III illness. Conclusion: These findings show that the clinical and associated features of depression differ between HIV-Positive and HIV-Negative patients, thus requiring different management approaches and further studies related to HIV-related depression.
2019
Clinical depression has been associated with various chronic disease conditions. The chronic course of HIV, fostered by the use of antiretroviral therapy in infected patients, puts them at risk of developing clinical depression which unfortunately, is often underdiagnosed and therefore undertreated. The study estimated the prevalence of depression and associated factors amongst adult patients receiving antiretroviral therapy in a clinic in Jos, using the PHQ-9 questionnaire. Three hundred and fourteen patients with a mean age of 45 ± 10 years were enrolled in a descriptive cross-sectional study. There were 63 males and 251 females, with mean known duration of HIV infection of 11 ± 4 years. Depression was found to be common in the group. Thirty one percent of the patients had depression, and of these, 83 (85%) had mild depression while 12 (12%) had moderate depression and 3 (3%) had moderately severe depression. The factors associated with depression in these patients were analysed u...
Background: Depression is a mental health condition that affects approximately 350 million people worldwide. People living with HIV and AIDS (PLWHA) are at increased risk of developing this condition. Identification of location-specific factors is crucial to minimizing this presentation in this sub-population. Aim: The aim of this study was to measure the prevalence, severity, and associated sociodemographic and comorbidity of depression among people living with HIV and AIDS in a laboratory setting in Yenagoa, southern Nigeria. Methods: This is a cross-sectional study carried out on 282 PLWHA, aged 18 years and over. They receive HIV screening services in the laboratory of the Federal Medical Center, Yenagoa from March to April 2017. Sociodemographic data of respondents and selected comorbidities were collected using a modified structured questionnaire from the World Health Organization STEPS tool. Retrieving CD4+ count results from the laboratory registry, and height, weight, and body mass index (BMI) were measured. The presence of depression was assessed using the Patients Health Questionnaire-9 tool and performed a multivariate logistic regression analysis to identify factors associated with depression with a 95% confidence level. Results: The mean age of the respondents was 40±8.8 years and most of them were females 195 (69.2%). Seventy-five (26.6%) of the respondents were depressed, of whom 10 (13.3%) had severe depression, while 41 (54.7%) had mild depression. The most common symptoms of depression were fatigue (30.1%) and dysphoria (28.7%). There was an association between depression and CD4+ count <350 cells/µL with an adjusted odds ratio (aOR) of 2.04 (95% CI: 1.14-3.63) and underweight with an aOR of 2.56 (95%CI: 1.01-6.47), while HAART with an aOR of 0.38 (95% CI: 0.18-0.84) was associated with decreased odds of developing depression. Conclusion: Depression appeared among a significant proportion of people living with HIV and AIDS in Yenagoa, southern Nigeria, and fatigue was the most common symptom of depression. Lack of HAART, low CD4+ count, and being underweight appear to be the major factors negatively associated with depression. There is therefore a need to ensure people living with HIV and AIDS continue to receive HAART to improve CD4+ count and increase BMI.
Nigerian Journal of Clinical Practice, 2013
Background: Depression is a common co-morbidity among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). It is associated with poor treatment adherence and higher mortality rates. Few reports have, however, emanated from developing countries where socioeconomic factors may confound this association. Materials and Methods: We conducted a cross-sectional comparative study of PLWHAs and apparently healthy staff of three LGA's. The depression module of the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN) and the Beck Depression Inventory (BDI) was used to diagnose depression and depression symptom severity, respectively. Results: Depression was commonly co-morbid among individuals with HIV/AIDS. It was five times more common in PLWHAs than in apparently healthy populations (29.3% vs. 7.3%, OR: 5.25, 95% CI: 2.50-11.76). A similar trend was observed for depression symptom severity. Among PLWHAs, depression was significantly more likely among females (OR: 7.91, 95% CI: 1.83-71.00, P < 0.01), those unemployed (OR: 2.94, 95% CI: 0.18-1.82, P < 0.04), and with an illness duration >3 years (OR: 7.90, P < 0.0001). Having at least one child (OR: 2.79, 95% CI: 1.25-6.16, P < 0.001) and living with others (OR: 4.71, 95% CI: 1.51-15.52, P < 0.003) significantly reduced depression risk. Conclusion: Depression was commonly co-morbid among PLWHAs studied. Clinicians should be aware of risk factors for depression among PLWHAs in order to improve treatment outcomes.
Journal of Affective Disorders, 2011
Introduction: depression, besides causing great psychological distress, may lead to poor academic performance and social relationships. Objective: to examine the prevalence of depressive symptoms in medical students from a northeastern region of Brazil. Methods: the population comprised 1024 students from first to twelfth semesters of two medical schools in Cariri, Ceará, Brazil. We used the questionnaire on sociodemographic characteristics and the Beck Depression Inventory II version. Results: the prevalence in this population for the diagnosis of depression was 28.8%.652 (63.7%) complied with all protocols to stay in research. After logistic regression, had a negative impact on studentsmental health: female Odds Ratio adjusted (ORa) (95% CI): 1.83 (1.19 to 2.82), reasonable physical health ORa (95% CI): 3.15 (2 0.09 to 4, 73), uncertainty about professional future ORa (95% CI): 2.97 (1.65 to 5.34), desire to change course ORa (95% CI): 2.51 (1.63 to 3.86), good social relationship but without participation in social activities ORa (95% CI): 1.96 (1.27 to 3.04), relationship difficulties ORa (95% CI): 11.40 (4.32 to 30.14) and rare leisure activities (95% CI): 2.45 (1.49 to 4.04) or eventual leisure activities ORa (95% CI): 3.04 (1.70 to 5.42). Conclusion: there was a high prevalence of depression among medical students in this region. Female, reasonable physical health, uncertainty over future career, desire to change course, do not participate in social activities and / or difficulties in relationships, sporadic or rare leisure activity were associated with increased risk of developing depressive symptoms.