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Shrestha S, Shakya Shrestha U, Priyanka J, Shrestha P. Depressive Symptoms among People Living with HIV Attending ART Centers of Lumbini Province, Nepal: A Cross-Sectional Study. AIDS Res Treat 2023; 2023:3526208. [PMID: 37908331 PMCID: PMC10615575 DOI: 10.1155/2023/3526208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/06/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Background Depression is a common mental disorder and is a leading cause of disability globally. Depressive symptoms among people living with HIV can be a significant barrier to ART initiation and thus lead to poor ART adherence. Global studies have found the prevalence of depressive symptoms among people living with HIV ranges from 12 to 63%. The real scenario of Nepal still needs to be explored. Thus, this study aimed to identify the prevalence and predictors of depression in individuals with HIV. Methods An institutional-based cross-sectional study was carried out from August to December 2020 among 406 people living with HIV attending ART centers in Lumbini province. Participants were selected using a systematic random sampling technique and surveyed with a structured questionnaire consisting of sociodemographic variables, HIV AIDS-related variables, and 21 items Beck Depression Inventory tool. The odds ratio was used as the ultimate measure of association, with a 95% confidence interval computed to establish statistical significance. A multivariate regression analysis was carried out to identify the final predictors of depressive symptoms. Results The study found that 26.8% of the respondents had depressive symptoms. Those who were literate (AOR = 0.24, 95% CI: 0.10-0.61), in the poorest wealth quintile (AOR = 7.28, 95% CI: 2.22-23.87), initiated ART within 12 months (AOR = 1.88, 95% CI: 1.03-3.42), had CD4 cell counts below 200 (AOR = 2.50, 95% CI: 1.54-4.06), and had a time difference of 3 months or less between HIV diagnosis and ART initiation (AOR = 0.50, 95% CI: 0.29-0.86) were independently associated with depressive symptoms. Conclusion Routine screening for depressive symptoms should be integrated into national HIV prevention and control programs for people living with HIV. An enabling environment should be created to facilitate the rapid enrollment of individuals newly diagnosed with HIV in ART services, thereby reducing the time gap between HIV diagnosis and ART initiation.
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Affiliation(s)
- Saneep Shrestha
- Department of Community Medicine, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | | | - Jyoti Priyanka
- Department of Community Medicine, Universal College of Medical Science and Teaching Hospital, Tribhuvan University, Bhairahawa, Rupandehi, Nepal
| | - Pragya Shrestha
- School of Nursing and Midwifery, Karnali Academy of Health Sciences, Jumla, Nepal
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Babalola OE, Badru OA, Bain LE, Adeagbo O. Determinants of social support among people living with HIV in Nigeria-a multicenter cross-sectional study. Front Public Health 2023; 11:1120192. [PMID: 37397754 PMCID: PMC10311506 DOI: 10.3389/fpubh.2023.1120192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
Background More than 38.4 million people were living with HIV worldwide in 2021. Sub-Saharan Africa bears two-thirds of the burden, with Nigeria having nearly two million people living with HIV (PLWH). Social support from social networks such as family and friends improve the quality of life, and reduces enacted and perceived stigma, but social support for PLWH remains suboptimal in Nigeria. This study aimed to assess the prevalence of social support and associated factors among PLWH in Nigeria and to test whether stigma reduces types of social support. Methods This cross-sectional study was conducted in Lagos State, Nigeria, between the months of June and July 2021. A total of 400 PLWH were surveyed across six health facilities providing antiretroviral therapy. Social support (family, friends, and significant others) and stigma were measured with the Multidimensional Scale of Perceived Social Support and Berger's HIV Stigma Scale, respectively. Binary logistic regression was used to identify determinants of social support. Results More than half (50.3%) of the respondents had adequate social support overall. The prevalence of family, friends, and significant others support was 54.3, 50.5, and 54.8%, respectively. Stigma (Adjusted Odds Ratio [AOR]: 0.945; 95% Confidence Interval [CI]: 0.905-0.987) was negatively associated with adequate friend support. Female gender (AOR: 6.411; 95% CI: 1.089-37.742), higher income (AOR: 42.461; 95% CI: 1.452-1241.448), and seropositive disclosure (AOR: 0.028; 95% CI: 0.001-0.719) were associated with adequate significant others support. Stigma (AOR:0.932; 95% CI: 0.883-0.983) was negatively associated with adequate support overall. Our findings corroborate the social support theory, as stigma reduces the chance of receiving social support. Conclusion PLWH that enjoy support from families or friends were less likely to be affected by HIV-related stigma. More support is needed by PLWH from family, friends, and significant others to improve the quality of life and reduce stigma among PLWH in Lagos State.
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Affiliation(s)
| | - Oluwaseun A. Badru
- Institute of Human Virology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Luchuo E. Bain
- International Development Research Centre (IDRC), Ottawa, ON, Canada
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Oluwafemi Adeagbo
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, United States
- Department of Sociology, University of Johannesburg, Johannesburg, South Africa
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Rajasuriar R, Li CM, Ross JL, Jiamsakul A, Avihingsanon A, Lee MP, Ditangco R, Choi JY, Gatechompol S, Chan I, Melgar MIE, Kim JH, Sohn AH, Law M. Factors associated with reduced function and quality of life among adult people with HIV with depression and substance use in the Asia-Pacific region. AIDS 2023; 37:823-835. [PMID: 36728672 PMCID: PMC10023402 DOI: 10.1097/qad.0000000000003474] [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] [Indexed: 02/03/2023]
Abstract
BACKGROUND Depression and substance use (SU) disorders are prevalent among people with HIV (PWH) and impact health outcomes despite successful antiretroviral therapy (ART). We explored quality of life, functional ability and associated factors among PWH screened positive for depression and/or SU. METHODS This cross-sectional study recruited adult PWH during routine follow-up at five HIV clinical sites in the Asia-Pacific region. Participants were screened for depression using Patient Health Questionnaire-9 and SU using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Quality of life (QoL) was assessed with WHOQOL-HIV BREF and functional ability with World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Factors associated with mean QoL and disability scores were analysed using linear regression. RESULTS Of 864 PWH enrolled, 753 screened positive for depression or SU. The median (interquartile range, IQR) age was 38 (31-47) years and 97% were on ART. Overall mean WHOQOL-HIV BREF and WHODAS scores indicated greater impairment with increasing depressive symptom severity and SU risk. In multivariate analysis, PWH reporting previous trauma/stress (difference = 2.7, 95% confidence interval [CI] 1.5-3.9, P < 0.001) and past mental health diagnosis (difference = 5.0, 95% CI 2.9-7.1, P < 0.001) were associated with greater disability and poorer QoL scores across multiple domains ( P < 0.01 for all). Higher CD4 T-cell counts was also associated with better QoL scores and functional ability. CONCLUSION PWH with depression/SU experienced poorer QoL and function despite routine engagement in HIV care. Efforts to integrate mental health services and interventions addressing disability into HIV management should be prioritized in the region.
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Affiliation(s)
- Reena Rajasuriar
- Department of Medicine and Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Chong Meng Li
- Department of Medicine and Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Jeremy L Ross
- TREAT Asia/amfAR – The Foundation for AIDS Research, Bangkok, Thailand
| | | | - Anchalee Avihingsanon
- HIV-NAT/ Thai Red Cross AIDS Research Centre, Bangkok and Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Thailand
| | | | - Rossana Ditangco
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sivaporn Gatechompol
- HIV-NAT/ Thai Red Cross AIDS Research Centre, Bangkok and Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Iris Chan
- Queen Elizabeth Hospital, Hong Kong SAR
| | - Maria Isabel Echanis Melgar
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
- Ateneo de Manila University, Quezon City, Philippines
| | - Jung Ho Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Annette H. Sohn
- TREAT Asia/amfAR – The Foundation for AIDS Research, Bangkok, Thailand
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Shabil M, Murti K, Kumar VU, Kumar R, Kumar N, Dhingra S, Parihar VK, Ravichandiran V, Pandey K. Older PLHIV are at Higher Cardiovascular Risk with Poor Quality of Life. Curr HIV Res 2023; 21:354-360. [PMID: 38141189 DOI: 10.2174/011570162x277586231218104922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND People with HIV (PLHIV) face increased cardiovascular disease (CVD) risk due to inflammation and immune activation. Aging further amplifies this risk. Limited data exist on CVD risk in older PLHIV in India despite 2.14 million PLHIV with higher CVD risk factors. METHODS In a cross-sectional study in Bihar, India, 73 PLHIV and 30 control participants were enrolled. Demographics, social factors, clinical information, and CVD risk factors were collected. HbA1c levels and lipid profiles were analyzed, and 10-year CVD risk scores were calculated using the Framingham risk score (FRS) and Qrisk3. Quality of life (QoL) was assessed using WHOQOL- HIV-BREF. RESULTS Results showed higher LDL levels in non-HIV older participants and higher HDL levels in younger PLHIV participants. BMI differed significantly, with higher BMI in non-HIV older individuals and lower BMI in younger PLHIV individuals. Older PLHIV participants had significantly higher mean FRS and Q-Risk scores compared to older non-PLHIV and younger PLHIV groups. Among older PLHIV participants, six had higher CVD risk per FRS, while none in the other groups were classified as high CVD risk. Psychological, social relations and spirituality domains were highly deteriorated in older PLHIV, scoring 44.48, 42.72, and 41.2, respectively. The physical domain scored 57.6, and the environment scored 52.72 in the WHOQOL-HIV bref. CONCLUSION In conclusion, older PLHIV in Bihar, India, face higher CVD risk compared to younger PLHIV and non-HIV individuals. FRS and Q-Risk scores effectively assessed CVD risk, identifying higher risk in older PLHIV. Age and BMI were significant predictors of high CVD risk. These findings emphasize CVD risk assessment and tailored management for older PLHIV. The QoL assessment findings indicate moderate deterioration in psychological, social relations, and spirituality domains among older PLHIV individuals. These results suggest greater challenges in psychological well-being, social interactions, and spirituality compared to the overall sample. Further research with larger samples and longitudinal designs is needed to confirm and extend these findings.
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Affiliation(s)
- Muhammed Shabil
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - V Udaya Kumar
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - Rishikesh Kumar
- Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkaun, Patna, Bihar, 800007, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - Vipan Kumar Parihar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and research, Hajipur, 844102, India
| | - V Ravichandiran
- Department of Natural Products, National Institute of Pharmaceutical Education and Research, Kolkata, West Bengal, 700032, India
| | - Krishna Pandey
- Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkaun, Patna, Bihar, 800007, India
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Nebhinani N, Mattoo S, Wanchu A. Quality of life, social support, coping strategies, and their association with psychological morbidity among people living with HIV. J Neurosci Rural Pract 2022; 13:725-729. [PMID: 36743764 PMCID: PMC9893948 DOI: 10.25259/jnrp-2022-6-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives Enhancement of quality of life and social support havebecome important therapeutic goals among people living with HIV. However, research from developing countries is sparse in this area. Index study was aimed to assess association of social support, coping, and quality of life with psychological morbidity among people living with HIV. Materials and Methods In this cross-sectional study, 100 people with HIV were recruited through purposive sampling who were not receiving antiretroviral therapy. To assess social support, coping, and quality of life social support questionnaire, coping strategy check list and World Health Organization quality of life-HIV BREF were administered, respectively. Results Quality of life domain scores fell in the moderate category and spirituality, religion, and personal belief domain had maximum score. Educated, married, employed, and male subjects reported better quality of life. Females reported greater use of internalization and emotional outlet coping strategies. Low social support, lower quality of life (in all domains and total score), and greater use of internalization coping strategy were significantly associated with psychiatric morbidity. Conclusion Internalization coping, low social support, and lower quality of life were associated with greater psychiatric morbidity. Therefore, to improve their mental health and overall course of HIV, multipronged interventions should be implemented for promoting the adaptive coping, social support and quality of life.
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Affiliation(s)
- Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Surendra Mattoo
- Consultant Psychiatrist, Newcastle North East Community Treatment Team, Cumbria, Northumberland, United Kingdom
| | - Ajay Wanchu
- Consultant Rheumatologist, Adventist Medical Center, Portland, Oregon, United States
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Zhang Y, Wan J, Ji L, Liu G, Shi Y, Zhao J, Li X. Does HIV-Related Stigma Depress Social Well-Being of Youths Affected by Parental HIV/AIDS? Front Psychiatry 2022; 13:898543. [PMID: 35815026 PMCID: PMC9260187 DOI: 10.3389/fpsyt.2022.898543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
Parental illness or death due to HIV/AIDS has long-term impacts on children's social well-being, potentially challenging the children's basic developmental needs and future. Based on the theoretical model of social well-being, the present study tested a moderated mediation model that HIV-related stigma moderated the mediating role of social trust on the relationship between perceived social support (PSS) and social well-being. A sample of 297 youths aged 20-30 years affected by parental HIV/AIDS (57.2% male), including 129 (43.40%) AIDS orphans and 168 vulnerable youths (56.60%) completed questionnaires of perceived social support, social well-being, social trust, and HIV-related stigma. IBM SPSS 25.0 was used to conduct descriptive statistics and multiple regressions. Results showed that the mean score of PSS was 61.34 (SD = 13.99), social well-being was 57.33 (SD = 10.15), social trust was 56.21 (SD = 11.55), perceived stigma was 64.44 (SD = 16.72), and enacted stigma was 21.91 (SD = 9.73) among youths affected by parental HIV/AIDS and the PSS could predict increasing social well-being via increasing social trust. Moreover, the positive influence of PSS on social trust was moderated by the enacted stigma (p = 0.03), in which the positive influence was stronger among youths affected by parental HIV/AIDS who perceived or experienced low enacted stigma than those who perceived or experienced high enacted stigma. The positive impact of social trust on social well-being was moderated by perceived stigma (p = 0.04), in which the positive impact was more significant among youths affected by parental HIV/AIDS who perceived or experienced high perceived stigma than those who perceived or experienced low perceived stigma. These findings explained how and when the PSS affected social well-being and contributed toward an understanding of the experiences and perceptions of HIV-related stigma among youths affected by parental HIV/AIDS. This understanding may inform future research and policies toward improving the social well-being of youths affected by parental HIV/AIDS. The study also highlighted the importance of strengthening interventions on social relations and reducing HIV-related stigma for them.
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Affiliation(s)
- Yafei Zhang
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Jiaojiao Wan
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Lili Ji
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Gaigai Liu
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Yixin Shi
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Junfeng Zhao
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Zhang X, Wang X, Wang H, He X, Wang X. Stigmatization and Social Support of Pregnant Women With HIV or Syphilis in Eastern China: A Mixed-Method Study. Front Public Health 2022; 10:764203. [PMID: 35359793 PMCID: PMC8961867 DOI: 10.3389/fpubh.2022.764203] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/28/2022] [Indexed: 01/10/2023] Open
Abstract
Background Stigmatization and poor social support are challenges faced by individuals living with HIV or sexually transmitted disease, which can have a profound negative impact on their healthcare. Mother-to-child transmission of either HIV or syphilis can lead to adverse maternal and fetal outcomes. The aim of this study was to investigate stigmatization and social support of pregnant women with HIV or syphilis in eastern China. Methods This was an explanatory sequential mixed-method study conducted in Zhejiang province, China in 2019. Stigmatization, social support, and the associated factors toward HIV or syphilis were evaluated using questionnaires. The social support rating scale was used to evaluate social support, where a score <25% was defined as poor social support. A logistic regression model was used to explore the association between stigmatization and poor social support. Results A total of 448 women (HIV positive, N = 93; syphilis, N = 355) were recruited in this study. Higher stigmatization was observed in pregnant women with HIV compared to those with syphilis (53.76% vs. 24.36%, p < 0.001), and poorer social support was observed in women with HIV compared with those with syphilis (40.86% vs. 19.86%, p < 0.001), with significant distributions of the total social support scores (Z = −1.976, p = 0.048) and scores on objectivity (Z = −2.036, p = 0.042) and subjectivity (Z = −2.500, p = 0.012). Similar social support among HIV or syphilis pregnant women was observed in medical healthcare facilities. In multivariable logistic model analysis, stigmatization (ORadj = 2.927; 95%CI, 1.714–4.996; p < 0.001) and ethnic minority (ORadj = 2.373; 95%CI, 1.113–5.056; p = 0.025) were negatively associated with social support. Interestingly, employment status was associated with improved social support (ORadj = 0.345; 95%CI, 0.180–0.662; p = 0.001). Conclusion Stigmatization among pregnant women with HIV or syphilis remains high. We demonstrated that stigmatization was a significant predictor of low social support in pregnant women with HIV or syphilis. The support shown in medical facilities was similar toward pregnant women with HIV or syphilis. Implementation of stigmatization eradication and social support strategies targeting pregnant women with HIV or syphilis may therefore improve the dual elimination of mother-to-child transmission service.
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Affiliation(s)
- Xiaohui Zhang
- Department of Women's Health, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Xiaoyan Wang
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Wang
- Department of Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Xinmei He
- Department of Women and Children's Health, Women and Children Health Care Hospital of Quzhou, Quzhou, China
| | - Xinyu Wang
- Department of Women's Health, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Women's Reproductive Health Key Laboratory of Zhejiang Province, Department of Gynecology and Obstetrics, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- *Correspondence: Xinyu Wang
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Johnson LCM, Desloge A, Sathish T, Williams ED, Absetz P, Haregu T, De Man J, Thankappan KR, Oldenburg B. The relationship between common mental disorders and incident diabetes among participants in the Kerala Diabetes Prevention Program (K-DPP). PLoS One 2021; 16:e0255217. [PMID: 34297780 PMCID: PMC8301665 DOI: 10.1371/journal.pone.0255217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 07/08/2021] [Indexed: 12/02/2022] Open
Abstract
This study aims to describe the prevalence of depression and anxiety among a population sample of people at high risk for type 2 diabetes in Kerala, India, and examine the relationship between depressive symptoms, anxiety, and incident Type 2 Diabetes Mellitus (T2DM) over a two-year period. We used data from the Kerala Diabetes Prevention Program, a cluster-randomized controlled trial for diabetes prevention among 1007 high-risk individuals. The prevalence of depression and anxiety were estimated using the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder 7-item scale, respectively. We calculated proportions for depression and anxiety and performed generalized estimating equations (GEE) to examine the relationship between baseline mental health status and incident T2DM. The prevalence of depression and anxiety at baseline were 7.5% and 5.5%, respectively. Compared with those reporting none/low symptoms, the odds ratio for incident diabetes was 1.07 (95% CI 0.54–2.12) for participants with moderate to severe depression and 0.73 (95% CI 0.23–2.28) for participants with moderate to severe anxiety, after adjusting for potential confounders. Our findings suggest that the prevalence of depression and anxiety were higher than those previously reported in the general population in India. However, among this sample of community-based adults at high risk of developing T2DM, the presence of moderate to severe depression and/or anxiety symptoms was not significantly associated with the risk of developing T2DM. Trial registration: Australia and New Zealand Clinical Trials Registry ACTRN12611000262909. Registered 10 March 2011.
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Affiliation(s)
- Leslie C. M. Johnson
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Allissa Desloge
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- MacMillan Center for International and Area Studies, Yale University, New Haven, Connecticut, United States of America
| | - Thirunavukkarasu Sathish
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Emily D. Williams
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Pilvikki Absetz
- Collaborative Care Systems Finland, Tampere University, Tampere, Finland
| | - Tilahun Haregu
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jeroen De Man
- Centre for General Practice, Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | | | - Brian Oldenburg
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
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