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Tsai YT, K. M. SP, Ku HC, Wu YL, Ko NY. Global overview of suicidal behavior and associated risk factors among people living with human immunodeficiency virus: A scoping review. PLoS One 2023; 18:e0269489. [PMID: 36940193 PMCID: PMC10029973 DOI: 10.1371/journal.pone.0269489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/22/2022] [Indexed: 03/21/2023] Open
Abstract
Death by suicide is a major public health problem. People living with human immunodeficiency virus (PLHIV) have higher risk of suicidal behavior than the general population. The aim of this review is to summarize suicidal behavior, associated risk factors, and risk populations among PLHIV. Research studies in six databases from January 1, 1988, to July 8, 2021, were searched using keywords that included "HIV," "suicide," and "risk factors." The study design, suicide measurement techniques, risk factors, and study findings were extracted. A total of 193 studies were included. We found that the Americas, Europe, and Asia have the highest rates of suicidal behavior. Suicide risk factors include demographic factors, mental illness, and physiological, psychological, and social support. Depression is the most common risk factor for PLHIV, with suicidal ideation and attempt risk. Drug overdosage is the main cause of suicide death. In conclusion, the current study found that PLHIV had experienced a high level of suicidal status. This review provides an overview of suicidal behavior and its risk factors in PLHIV with the goal of better managing these factors and thus preventing death due to suicide.
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Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Sriyani Padmalatha K. M.
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Operating Room Department, National Hospital of Sri Lanka, Colombo, Sri
Lanka
| | - Han-Chang Ku
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
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Jiang H, Chen S, Huang X, Huang R, Lin P, Cheng W, Xu M, Yang F, Liu J, Li Y, Gao Y, Yang Y. Prevalence of and factors associated with major depressive disorder among HIV-positive individuals in Guangdong, China. J Affect Disord 2019; 246:474-479. [PMID: 30599371 DOI: 10.1016/j.jad.2018.12.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/03/2018] [Accepted: 12/25/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND People living with HIV may suffer from mental disorders. We aimed to explore the prevalence of and factors associated with major depressive disorder (MDD) among HIV-positive individuals in Guangdong, China, about which little is known. METHODS A cross-sectional study was conducted to recruit HIV-positive individuals from the Centers for Disease Prevention and Control of Guangzhou, Zhongshan, and Yangjiang from September 2007 to September 2008. Data were collected by questionnaires. MDD was diagnosed and assessed by two psychiatrists using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P) based on the DSM-IV criteria. Multiple logistic regression analyses were conducted to explore the factors associated with MDD. RESULTS The prevalences of lifetime MDD and current MDD among the 339 included participants were 22.71% (95% confidence interval [CI]: 18.25-27.17%) and 12.09% (95%CI: 8.62%-15.57%), respectively. The results of multiple logistic regression showed that patients with AIDS had a higher risk of lifetime MDD (odds ratio [OR] = 2.69, 95%CI: 1.38-5.26) and current MDD (OR = 3.51, 95%CI: 1.59-7.75) than HIV-infected individuals. Participants with more number of negative life events were more likely to have lifetime MDD (OR = 2.33, 95%CI: 1.34-4.06) and current MDD (OR = 3.77, 95%CI: 1.76-8.09) than individuals with fewer negative life events. Individuals with higher score of social support were less likely to have lifetime MDD (OR = 0.45, 95%CI: 0.26-0.80) and current MDD (OR = 0.46, 95%CI: 0.21-0.97) than individuals with less social support. CONCLUSIONS The prevalence of MDD was high among HIV-positive individuals in China. AIDS diagnosis, decreased social support, and an increased number of negative life events were risk factors for MDD.
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Affiliation(s)
- Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Shuyi Chen
- The Second People's Hospital of Bao'an District (Group) General Hospital, Shenzhen, China
| | | | - Ruoyan Huang
- Guangzhou Psychiatric Hospital, Guangzhou, China
| | - Peng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weibin Cheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Meizhen Xu
- Haizhu District Center for Disease Control and Prevention, Guangzhou, China
| | - Fang Yang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Liu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yanhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China.
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Shi Y, Zhao M, Chen S, Wang S, Li H, Ying J, Zhang M, Li Y, Xing Z, Sun J. Effects of cognitive behavioral therapy on people living with HIV and depression: A systematic review and meta-analysis. PSYCHOL HEALTH MED 2018; 24:578-594. [PMID: 30479159 DOI: 10.1080/13548506.2018.1549739] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this review is to examine the efficacy of cognitive behavioral therapy (CBT) on people living with HIV (PLWH) and depression. A literature search from five electronic databases was conducted, and articles published until July 2017 were collected. The inclusion criteria included randomized controlled trials (RCTs) of CBT that were conducted among PLWH with clinically relevant depression. Comprehensive Meta-Analysis 2 was used to obtain pooled results. Seven RCTs, with a total sample size of 388 participants, met the inclusion criteria. Compared with the control group, the CBT group had statistically significant, short-term improvements in depression (g = -0.486, 95% CI [-0.969 to -0.003], P = 0.048). A significant reduction in viral load was also observed at the long-term follow-up (g = -0.306, 95% CI [-0.573 to -0.040], P = 0.024), but no improvements were found in CD4. Results of this meta-analysis showed that CBT is effective in reducing depression symptoms in PLWH with comorbid depression for a short period of time. However, the findings of this review may not be generalized in the clinical field due to the small number of involved studies and the limited study sample. Thus, more robust and adequately powered studies are needed to further explore CBT interventions in PLWH with depression.
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Affiliation(s)
- Ying Shi
- a School of Nursing , Jilin University , Changchun , People's Republic of China.,b School of Nursing , Hubei University of Medicine , Shiyan , People's Republic of China
| | - Minghui Zhao
- c Department of Endocrinology , The Second Hospital of Jilin University , Changchun , People's Republic of China
| | - Si Chen
- d The First Bethune Hospital of Jilin University , Changchun , People's Republic of China
| | - Shouqi Wang
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Huanhuan Li
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Jie Ying
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Meiling Zhang
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Yuan Li
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Zhuangjie Xing
- a School of Nursing , Jilin University , Changchun , People's Republic of China
| | - Jiao Sun
- a School of Nursing , Jilin University , Changchun , People's Republic of China
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Liu Y, Niu L, Wang M, Chen X, Xiao S, Luo D. Suicidal behaviors among newly diagnosed people living with HIV in Changsha, China. AIDS Care 2017; 29:1359-1363. [PMID: 28593797 DOI: 10.1080/09540121.2017.1338653] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Newly-diagnosed people living with HIV (NPLWH) are at high risk of suicide. We aimed to evaluate the prevalence of suicidal behaviors among NPLWH, and explore the relationships between HIV-related stress, depression, anxiety, and social support and suicidal ideation after diagnosed with HIV infection. A cross-sectional study was conducted using a standard set of questionnaires during 1 March 2013 and 30 September 2014 in the HIV/AIDS Voluntary Counseling and Testing Clinic of the Changsha Center for Disease Control and Prevention. Among 557 NPLWH, 27.5% (n = 153) had lifetime suicidal ideation, and 25.0% (n = 139) had suicidal ideation after HIV diagnosis. The results of multiple regression analyses indicated that suicidal ideation after HIV diagnosis was associated with HIV-related clinical symptoms (OR = 2.50), HIV-related stress (OR = 3.64), the co-morbidity of positive depressive and anxiety symptoms (OR = 3.30), and social support (OR = 0.52). Overall, the prevalence of suicidal behaviors is high among NPLWH in Changsha emphasizing the need of suicidality monitoring and tracking, depression and anxiety screening, with an additional focus on stress management and social support enhancement in this vulnerable group.
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Affiliation(s)
- Ying Liu
- a Department of Social Medicine and Health Management , Xiangya School of Public Health, Central South University , Changsha , China
| | - Lu Niu
- a Department of Social Medicine and Health Management , Xiangya School of Public Health, Central South University , Changsha , China.,b Department of Psychiatry , University of Rochester Medical Center , Rochester , NY , USA
| | - Min Wang
- c Changsha Infectious Disease Hospital , Changsha , China
| | - Xi Chen
- d Changsha Center for Disease Control and Prevention , Changsha , China
| | - Shuiyuan Xiao
- a Department of Social Medicine and Health Management , Xiangya School of Public Health, Central South University , Changsha , China
| | - Dan Luo
- a Department of Social Medicine and Health Management , Xiangya School of Public Health, Central South University , Changsha , China.,b Department of Psychiatry , University of Rochester Medical Center , Rochester , NY , USA
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Kanmogne GD, Qiu F, Ntone FE, Fonsah JY, Njamnshi DM, Kuate CT, Doh RF, Kengne AM, Tagny CT, Nchindap E, Kenmogne L, Mbanya D, Cherner M, Heaton RK, Njamnshi AK. Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender. PLoS One 2017; 12:e0171956. [PMID: 28231258 PMCID: PMC5322951 DOI: 10.1371/journal.pone.0171956] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 01/27/2017] [Indexed: 12/03/2022] Open
Abstract
Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden.
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Affiliation(s)
- Georgette D. Kanmogne
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- * E-mail:
| | - Fang Qiu
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Félicien E. Ntone
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Julius Y. Fonsah
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Dora M. Njamnshi
- HIV-Day Care Service, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Callixte T. Kuate
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Roland F. Doh
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Anne M. Kengne
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Claude T. Tagny
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | | | | | - Dora Mbanya
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Mariana Cherner
- HIV Neurobehavioral Research Center, School of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Robert K. Heaton
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, San Diego, California, United States of America
| | - Alfred K. Njamnshi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
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Niu L, Luo D, Liu Y, Silenzio VMB, Xiao S. The Mental Health of People Living with HIV in China, 1998-2014: A Systematic Review. PLoS One 2016; 11:e0153489. [PMID: 27082749 PMCID: PMC4833336 DOI: 10.1371/journal.pone.0153489] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 03/30/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Understanding the mental health burdens faced by people living with HIV in China is instrumental in the development of successful targeted programs for psychological support and care. METHODS Using multiple Chinese and English literature databases, we conducted a systematic review of observational research (cross-sectional, case-control, or cohort) published between 1998 and 2014 on the mental health of people living with HIV in China. RESULTS We identified a total of 94 eligible articles. A broad range of instruments were used across studies. Depression was the most widely studied problem; the majority of studies reported prevalence greater than 60% across research settings, with indications of a higher prevalence among women than men. Rates of anxiety tended to be greater than 40%. Findings regarding the rates of suicidality, HIV-related neurocognitive disorders, and substance use were less and varied. Only one study investigated posttraumatic stress disorder and reported a prevalence of 46.2%. Conflicting results about health and treatment related factors of mental health were found across studies. CONCLUSIONS Despite limitations, this review confirmed that people living with HIV are vulnerable to mental health problems, and there is substantial need for mental health services among this population.
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Affiliation(s)
- Lu Niu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Dan Luo
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Ying Liu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
| | - Vincent M. B. Silenzio
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
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Serafini G, Montebovi F, Lamis DA, Erbuto D, Girardi P, Amore M, Pompili M. Associations among depression, suicidal behavior, and quality of life in patients with human immunodeficiency virus. World J Virol 2015; 4:303-312. [PMID: 26279991 PMCID: PMC4534821 DOI: 10.5501/wjv.v4.i3.303] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/19/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus (HIV) patients.
METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015.
RESULTS: Based on the main findings, the prevalence of major depressive disorder (MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV.
CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV.
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Symptoms of depression and rates of neurocognitive impairment in HIV positive patients in Beijing, China. J Affect Disord 2014; 162:89-95. [PMID: 24767011 DOI: 10.1016/j.jad.2014.03.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 03/15/2014] [Accepted: 03/17/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND In China an estimated 780,000 people are living with HIV (PLWH). In high-income countries PLWH are at increased risk of depression, with subsequent adverse consequences for quality of life, and HIV-related morbidity and mortality. There are few data from low-and middle-income countries. The aims of this country-specific investigation of the Asia Pacific NeuroAIDS Consortium (APNAC) study were to establish the point prevalence, severity and HIV-related and non-HIV related correlates of depressive symptoms in PLWH, in Beijing, China. METHOD PLWH attending an outpatient clinic at Ditan Hospital, Beijing were recruited consecutively. Data sources were: study-specific questions about demographic characteristics, and health behaviours, the Centre for Epidemiological Studies Depression Scale (CES-D), the World Health Organisation Self-Reporting Questionnaire (SRQ-20) translated into Mandarin and administered as structured individual interviews, and a screen battery of four standard neuropsychological tests. RESULTS In total 50/51 (98%) eligible patients agreed to participate. Overall 28% scored CES-D≥16 or SRQ20≥10 and 18% in these clinical ranges on both measures; 69% were classified as being neuropsychologically impaired (scoring below 1 SD of the control value on at least two tests). Higher depressive symptom scores were associated with lower education, alcohol overuse and diminished motor ability (all p<0.05), but not neuropsychological impairment CONCLUSION Clinically significant depressive symptoms among this cohort of PLWH in Beijing occurred at 5 times the rate reported among a general Chinese urban population. No participants had been assessed for depression prior to the study and none were treated, indicating that consideration of psychological morbidity and its consequences for health behaviours should be incorporated into routine HIV care in China.
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Kamat R, Morgan E, Marcotte TD, Badiee J, Maich I, Cherner M, de Almeida S, de Pereira AP, Ribeiro CE, Barbosa F, Atkinson JH, Ellis R. Implications of apathy and depression for everyday functioning in HIV/AIDS in Brazil. J Affect Disord 2013; 150:1069-75. [PMID: 23245465 PMCID: PMC3619015 DOI: 10.1016/j.jad.2012.11.040] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 11/20/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Brazil accounts for the largest number of HIV+ persons in Latin America, and this epidemic poses a significant public health burden in this country. Little is known about the neuropsychiatric and functional consequences of HIV infection in this population. METHODS Participants were 43 HIV+ and 29 HIV- individuals who underwent a neuropsychological, psychiatric and neurological evaluation that included self-report measures of mood (Beck Depression Inventory-II; BDI-II), neurocognitive complaints (Patient's Assessment of Own Functioning Inventory) and declines in instrumental activities of daily living (Activities of Daily Living questionnaire). The MINI-Plus generated major depressive disorder (MDD) diagnoses. Apathy, defined as social withdrawal, decision-making difficulty, loss of interest and pleasure, was measured using items from the BDI-II and the neurological evaluation. RESULTS When compared with seronegative participants, HIV+ individuals endorsed higher levels of apathy spectrum symptoms. After adjusting for mood and other covariates, apathy significantly predicted worse everyday functioning. LIMITATIONS The small sample size, along with the self-report measures used to evaluate apathy and functional difficulties limit the inferences that may be drawn from our findings. CONCLUSIONS Our Brazilian HIV+ cohort endorsed apathy and depression as well as significant functional complaints. Although correlated with depression, apathy was uniquely associated with functional difficulties. Clinical attention to apathy and depression in HIV-infected Brazilians may help identify patients at risk for functional difficulties who may benefit from additional support to maintain independence.
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Affiliation(s)
- Rujvi Kamat
- San Diego University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA.
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Su X, Lau JTF, Mak WWS, Choi KC, Chen L, Song J, Zhang Y, Zhao G, Feng T, Chen X, Liu C, Liu J, Liu D, Cheng J. Prevalence and associated factors of depression among people living with HIV in two cities in China. J Affect Disord 2013; 149:108-15. [PMID: 23452645 DOI: 10.1016/j.jad.2013.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Depression has significant effects on morbidity and mortality in people living with HIV (PLWH). Current study estimated the rate of depressive disorder and identified the correlates of depressive disorder among PLWH in China. METHODS 258 PLWH in China were recruited and interviewed with a structured questionnaire including measurements testing perceived stress, social support, perceived discrimination, and depression. Mediating effect of perceived stress between perceived discrimination and depression and moderating effect of social support on effect of perceived discrimination and perceived stress to depression were tested. Multivariate regression was used to examine the determinants of depression. RESULTS The prevalence of mild to severe depression is 71.9%. The relationship between the perceived discrimination and depression is fully mediated by perceived stress (perceived discrimination that was statistically significant (β=0.153) to depression became non-significant after adding perceived stress in the regression model). Interaction term between social support and perceived stress has negative effects (β=-0.117) and explained a significant amount of variance (R(2)=0.018) in depression. Lower income, and higher perceived stress predicted more depressive symptoms. LIMITATIONS Cross-sectional study and self-report bias are major limitations of this study. CONCLUSION Depression among PLWH is a severe problem in China. Primary health care workers need to be trained in recognition and treatment in depression. Stress management skills and social support for PLWH are warranted.
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Affiliation(s)
- Xiaoyou Su
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Rezaei S, Taramian S, Kafie SM. Psychopathological Dimensions in Substance Abusers with and without HIV/AIDS and Healthy Matched Group. ADDICTION & HEALTH 2013; 5:115-25. [PMID: 24494168 PMCID: PMC3905475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 01/23/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Inattention to symptoms of mental disorders and substance abuse in patients with HIV/AIDS and other at-risk groups, may lead to irreversible damages. The purpose of this study was to compare the psychopathological dimensions in substance abusers with and without HIV/AIDS and healthy matched groups. METHODS In a cross-sectional and analytical study, selected samples (by available, consecutive, and objective methods) were 43 HIV-positive substance abusers, 49 HIV negative substance abusers under methadone maintenance therapy (MMT) in the counseling clinic of Behavioral Diseases and Addiction Abandonment, and 45 ordinary individuals. All of them were evaluated by matched confounding variables via Symptom Checklist-90-Revised (SCL-90-R). FINDINGS Results indicated a significant difference between these groups in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST) (P < 0.001). Two by two the comparison of the three groups from psychopathological dimensions revealed that substance abusers with HIV/AIDS persistently suffer more mental problems in all dimensions compared with healthy individuals (P < 0.05). In addition, in comparison with HIV negative substance abusers, they also suffer more mental problems in other dimensions, including somatization, interpersonal sensitivity, depression, anxiety, phobia, and psychoticism (P < 0.05). Yet, the difference in paranoid ideation, hostility, and obsessive-compulsive cases was insignificant. Two by two, the comparison between healthy individuals and substance abusers without HIV/AIDS showed higher levels of depression and psychoticism in substance abusers (P < 0.05), but no difference in other dimensions. CONCLUSION Comorbidity of substance abuse and HIV diagnosis intensify mental disorder symptoms. Moreover, lack of prevention and implementation of appropriate psychological and psychiatric interventions after substance abuse and HIV lead to extended establishment of mental disorder symptoms.
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Affiliation(s)
- Sajjad Rezaei
- Student Counseling Office, Guilan University of Medical Sciences, Rasht, Iran,Correspondence to: Sajjad Rezaei MSc,
| | - Sonbol Taramian
- Assistant Professor, Department of Infectious Diseases, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Mousa Kafie
- Associate Professor, Department of Psychology, University of Guilan, Rasht, Iran
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