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Omann LR, Dushimiyimana V, Musoni-Rwililiza E, Arnbjerg CJ, Niyonkuru VU, Iyamuremye JD, Gasana M, Carlsson J, Kallestrup P, Kraef C. Prevalence of Mental Health Disorders and Their Associated Risk Factors Among People Living with HIV in Rwanda: A Cross-Sectional Study. AIDS Behav 2024:10.1007/s10461-024-04358-3. [PMID: 38736005 DOI: 10.1007/s10461-024-04358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30-3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings.
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Affiliation(s)
- Laura Risbjerg Omann
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark.
| | | | - Emmanuel Musoni-Rwililiza
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- College of Medicine and Health Sciences University of Rwanda, Kigali, Rwanda
- Mental Health Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Caroline Juhl Arnbjerg
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- College of Medicine and Health Sciences University of Rwanda, Kigali, Rwanda
| | | | | | | | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per Kallestrup
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
- Research Unit for General Practice, Aarhus, Denmark
| | - Christian Kraef
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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Barger D, Hessamfar M, Neau D, Farbos S, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Rispal P, Dabis F, Wittkop L, Bonnet F. Factors associated with poorer quality of life in people living with HIV in southwestern France in 2018-2020 (ANRS CO3 AQUIVIH-NA cohort: QuAliV study). Sci Rep 2023; 13:16535. [PMID: 37783722 PMCID: PMC10545822 DOI: 10.1038/s41598-023-43434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023] Open
Abstract
We evaluated people living with Human Immunodeficiency Virus' (PLWH) quality of life (QoL) and assessed whether their demographic, disease-related, socioeconomic, or behavioral characteristics were associated with poorer QoL. ANRS CO3 AQUIVIH-NA cohort participants (Nouvelle Aquitaine, France) were recruited to a cross-sectional study (2018-2020) and their QoL assessed (WHOQOL-BREF). We calculated median (Q1, Q3) QoL domain scores and assessed factors associated with poorer median QoL using bivariable and multivariable quartile regression. Of the 965 PLWH included, 98.4% were on antiretroviral therapy, 94.7% were virally-suppressed, 63.5% reported good/very good QoL. Median scores (0-100) were highest for physical (69;Q1, Q3: 56, 81) and environmental (69; 56, 75) QoL and lowest for social (56; 44, 69) and psychological (56; 44, 69) QoL. PLWH with ≥ 3 comorbidities, HIV-related stigma, or income of < 1500€/month had poorer median adjusted physical, psychological, social, and environmental QoL scores compared to reference groups. While more than half of PLWH reported good/very good QoL, we have not achieved good QoL in 90% of PLWH. Multi-morbidity, HIV-related stigma, and social determinants were consistently and independently associated with poorer QoL. Addressing structural factors in addition to those indirectly related to HIV is required to attain good QoL in all PLWH.
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Affiliation(s)
- Diana Barger
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France.
| | - Mojgan Hessamfar
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 33000, Bordeaux, France
| | - Didier Neau
- CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, 33000, Bordeaux, France
| | - Sophie Farbos
- CH de la Côte Basque, Service de Maladies Infectieuses, 64000, Bayonne, France
| | - Olivier Leleux
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
| | - Charles Cazanave
- CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, 33000, Bordeaux, France
| | - Nicolas Rouanes
- CH de Périgueux, Service de Médecine Polyvalente, 24019, Périgueux, France
| | - Pierre Duffau
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000, Bordeaux, France
| | - Estibaliz Lazaro
- CHU de Bordeaux, Service de Médecine Interne, 33604, Pessac, France
| | - Patrick Rispal
- CH de Agen-Nerac, Service de Médecine Interne, 47923, Agen, France
| | - François Dabis
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 33000, Bordeaux, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
- INRIA, SISTEM Team, 33400, Talence, France
- CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, 33000, Bordeaux, France
| | - Fabrice Bonnet
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
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Mazzitelli M, Trunfio M, Milinkovic A, Castelli E, Sasset L, Leoni D, Salvucci M, Cazzaro R, Calcinoni I, Balducci P, Ribeiro GCQ, Filagrana G, Scaglione V, Cattelan AM. Sleep disturbances and their correlation with cardiovascular risk, obesity, and mood disorders in people with HIV. AIDS 2023; 37:925-934. [PMID: 36723511 DOI: 10.1097/qad.0000000000003493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The relationship between sleep disorders (SDs), cardiovascular risk (CVR), and mood disorders (MDs) has been studied in detail in the general population, but far less in people with HIV (PWH). METHODS Cross-sectional analysis in single centre cohort of PWH. Sleep quality was assessed using by Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Berlin Questionnaire (BQ), Pittsburgh Sleep Quality Index (PSQI); anxiety and depression were evaluated by the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Demographic, clinical and HIV-related data were collected, and Framingham and Data collection on Adverse effects of anti-HIV Drugs (DAD)-10 scores were computed in modelling associations with each SDs scale. RESULTS Data were collected for 721 PWH on stable combination antiretroviral therapy (cART) (median age of 53 years, 71.8% males, 96% with undetectable HIV RNA, 50.3% on cART potentially affecting sleep, and 20.4% on hypno-inducing drugs), 76.9% had SDs 60.3, 31.3, 31.1, and 7.9% at PSQI, BQ, ISI, and ESS, respectively. Anxiety and depression were detected in 28.3 and 16.1% participants, respectively. BQ score was independently associated with high BMI ( P < 0.001), Framingham risk >10% ( P < 0.001), and both DAD-10R and -10F score >10% ( P < 0.001 and P = 0.031). PSQI and ISI scores were independently associated with depression and anxiety ( P < 0.001). No association between SDs and specific antiretroviral regimens, nor HIV-related parameters was detected. CONCLUSIONS In our cohort of PWH on stable ART, despite the alarmingly higher prevalence, SDs were associated with the same determinants (cardiovascular risk factors and MDs) observed in the general population.
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Affiliation(s)
- Maria Mazzitelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Mattia Trunfio
- Infectious Diseases Unit, Department of Medical Sciences, University of Turin at Amedeo di Savoia Hospital, Turin, Italy
- HIV Neurobehavioral Research Program and Departments of Neurosciences and Psychiatry, School of Medicine, University of California, San Diego, California, USA
| | - Ana Milinkovic
- Chelsea and Westminster Foundation Trust
- Imperial College London, London, UK
| | - Eleonora Castelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Lolita Sasset
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Davide Leoni
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | | | | | | | | | | | | | - Vincenzo Scaglione
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Anna M Cattelan
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
- Student at University of Padua, Padua University Hospital
- University of Padua, Padua, Italy
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Xia W, Xu Y, Gong Y, Cheng X, Yu T, Yu G. Microglia Involves in the Immune Inflammatory Response of Poststroke Depression: A Review of Evidence. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2049371. [PMID: 35958023 PMCID: PMC9363171 DOI: 10.1155/2022/2049371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022]
Abstract
Poststroke depression (PSD) does not exist before and occurs after the stroke. PSD can appear shortly after the onset of stroke or be observed in the weeks and months after the acute or subacute phase of stroke. The pathogenesis of PSD is unclear, resulting in poor treatment effects. With research advancement, immunoactive cells in the central nervous system, particularly microglia, play a role in the occurrence and development of PSD. Microglia affects the homeostasis of the central nervous system through various factors, leading to the occurrence of depression. The research progress of microglia in PSD has been summarized to review the evidence regarding the pathogenesis and treatment target of PSD in the future.
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Affiliation(s)
- Weili Xia
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
| | - Yong Xu
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
| | - Yuandong Gong
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
| | - Xiaojing Cheng
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
| | - Tiangui Yu
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
| | - Gongchang Yu
- Shandong Mental Health Center, Shandong University, Jinan, Shandong 250014, China
- Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250062, China
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