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Lee S, Oh JW, Park KM, Ahn JY, Lee S, Lee E. The prevalence and moderating factors of sleep disturbances in people living with HIV: a systematic review and meta-analysis. Sci Rep 2024; 14:14817. [PMID: 38937605 PMCID: PMC11211430 DOI: 10.1038/s41598-024-65713-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: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
This systematic review and meta-analysis aimed to investigate the prevalence of self-reported sleep disturbances in people living with HIV considering the effects of age, depression, anxiety, CD4 cell counts, time since HIV diagnosis, study region, and the instruments used to measure sleep disturbances. We searched PubMed, PsycINFO, and EMBASE to include eligible articles. In this meta-analysis of 43 studies, the pooled prevalence of self-reported sleep disturbances was 52.29% (95% confidence interval 47.69-56.87). The subgroup analyses revealed that variations in the sleep measurements and study region significantly contributed to the observed heterogeneity. In the meta-regression analyses, higher proportions of participants with depression or anxiety and longer times since HIV diagnosis were significantly associated with a higher prevalence of self-reported sleep disturbances after adjusting for mean age. Our findings emphasise the substantial burden of sleep disturbances in people living with HIV and identified comorbid depression and anxiety and the time since HIV diagnosis as significant moderators. These results underscore the importance of considering these factors when designing tailored screening programmes for high-risk patients and implementing early interventions to prevent and mitigate sleep disturbances in people living with HIV.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae Won Oh
- Department of Psychology, The University of Utah Asia Campus, Incheon, Republic of Korea
| | - Kyung Mee Park
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jin Young Ahn
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
| | - Eun Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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2
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Alinaitwe R, Elyanu PJ, Kanywa JB, Akena D. Use of computer-assisted self-interview in detection of and referral for depression among adolescents living with HIV at an urban HIV treatment clinic in Uganda: a quasi-experimental study. BMJ Paediatr Open 2024; 8:e002383. [PMID: 38886110 PMCID: PMC11184185 DOI: 10.1136/bmjpo-2023-002383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/22/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Depression is common among adolescents living with HIV (ALHIV) and impacts their quality of life. However, it is not routinely detected and treated due to a lack of screening tools, coupled with large numbers of clients in the HIV clinics and limited staff. Enabling adolescents to do a self-assessment for depression on a tablet computer could possibly improve the detection of depression in this population. We set out to assess the detection and referral of depression among ALHIV in care in Uganda. METHODS This was a quasi-experimental study design with a historical control at Baylor College of Medicine of Children's Foundation. We conducted a retrospective chart review of 425 adolescents covering a 3-month period and documented the proportion screened for depression and referred to the clinic counsellors. From July to September 2022, eligible adolescents aged 10-19 years who had assented and consented self-assessed for depression using a Patient Health Questionnaire-Adolescent on a tablet computer-assisted self-interview (CASI). Adolescents who screened positive had a prompt on the tablet computers referring them to the counsellor for mental healthcare. We compared the proportions of participants screened for depression and referred to counsellors from clinic chart review and on the CASI using paired t-tests. RESULTS Out of 425 medical records reviewed, 54% (231/425) were females and the median age was 15 years. Of the participants who self-assessed on the CASI, 52% (222/425) were males and the median age of all participants was 16 years. Self-assessment on the CASI increased the rate of detection of depression from 0% to 23.3%. Of those referred on the CASI, 15% accessed care at the referral point. CONCLUSION The use of CASI improves the rate of detection of depression among ALHIV; however, there is a need to address the barriers to effective referral for mental health services.
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Affiliation(s)
| | | | | | - Dickens Akena
- Makerere University College of Health Sciences, Kampala, Uganda
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3
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Liu J, Liu Y, Ma W, Tong Y, Zheng J. Temporal and spatial trend analysis of all-cause depression burden based on Global Burden of Disease (GBD) 2019 study. Sci Rep 2024; 14:12346. [PMID: 38811645 PMCID: PMC11137143 DOI: 10.1038/s41598-024-62381-9] [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: 09/20/2023] [Accepted: 05/16/2024] [Indexed: 05/31/2024] Open
Abstract
Depression has been reported as one of the most prevalent psychiatric illnesses globally. This study aimed to obtain information on the global burden of depression and its associated spatiotemporal variation, by exploring the correlation between the global burden of depression and the social development index (SDI) and associated risk factors. Using data from the Global Burden of Disease study from 1990 to 2019, we described the prevalence and burden of disease in 204 countries across 21 regions, including sex and age differences and the relationship between the global disease burden and SDI. The age-standardized rate and estimated annual percentage change were used to assess the global burden of depression. Individuals with documented depression globally ranged from 182,183,358 in 1990 to 290,185,742 in 2019, representing an increase of 0.59%. More patients experienced major depressive disorder than dysthymia. The incidence and disability-adjusted life years of depression were the highest in the 60-64 age group and much higher in females than in males, with this trend occurring across all ages. The age-standardized incidence and adjusted life-years-disability rates varied with different SDI levels. Relevant risk factors for depression were identified. National governments must support research to improve prevention and treatment interventions.
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Affiliation(s)
- Junjiao Liu
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yueyang Liu
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Wenjun Ma
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yan Tong
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Jianzhong Zheng
- College of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
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4
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Bourne K, Croston M, Hurt E, Galbraith N, Hayter M. What is known from the existing literature about how sleep is measured in HIV care? A scoping review. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S10-V. [PMID: 38194326 DOI: 10.12968/bjon.2024.33.1.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
The HIV care landscape has significantly altered over the past 30 years with advances in HIV medical treatment. Despite these medical advances, people living with HIV experience a significant number of issues that affect their health-related quality of life, including sleep. Although poor sleep quality is common, there remains a lack of understanding of how to identify sleep issues in order to improve outcomes for people living with HIV. A scoping review of three databases as well as the grey literature yielded 2932 articles, of which 60 met the inclusion criteria. The following themes were identified: range of methods used to assess sleep, self-reported sleep measures and objective measures of sleep. The review found that a number of different measures of sleep were used within the research, the most commonly used being the Pittsburgh Sleep Quality Index. Due to the variety of approaches being used to measure sleep (n=18) there was a lack of consistency in what aspects of sleep were being explored, and in many cases why the measure of sleep was chosen. Furthermore, there was a lack of meaningful clinical recommendations as to how these findings could be used to improve outcomes for people living with HIV.
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Affiliation(s)
- Kathryn Bourne
- Clinical Psychologist, Department of Infectious Diseases, Manchester University NHS Foundation Trust, and Lecturer in Clinical Psychology, Faculty of Health and Medicine, Lancaster University
| | - Michelle Croston
- Associate Professor of Nursing, School of Health Sciences, University of Nottingham, Nottingham
| | - Emily Hurt
- Research Assistant, Manchester Metropolitan University
| | | | - Mark Hayter
- Professor and Head of Nursing, Manchester Metropolitan University
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5
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Jones MC, Byun JY, Billings R, Shorten A, Kempf MC, Vance DE, Puga F. Tools for Screening and Measuring Anxiety Among Women Living with HIV of Reproductive Age: A Scoping Review. AIDS Behav 2023:10.1007/s10461-023-03990-9. [PMID: 36757556 DOI: 10.1007/s10461-023-03990-9] [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: 01/10/2023] [Indexed: 02/10/2023]
Abstract
Emerging evidence suggests that women living with HIV (WLWH) may experience higher rates of anxiety than men living with HIV and women living without HIV. To date, relatively little knowledge exists on valid anxiety screening and diagnostic tools and how they are used among WLWH, specifically WLWH of reproductive age. Thus, the purpose of this scoping review was to describe what is known in the published literature about anxiety among WLWH and the tools used to measure and screen for anxiety in clinical and research contexts. The Arksey and O'Malley methodological framework was used to guide a scoping review of published articles in PsycINFO, Scopus, Sociological Abstracts, and PubMed databases. Twenty-one measures of anxiety were used across the 52 articles identified in the search. Most measures used were self-report. Inconsistencies in standardized screening tools and cutoff scores were observed across studies. Further, measures to assess anxiety varied among studies focused on WLWH. Based on the results from this review, there is a need for consistent, valid measures of anxiety to advance research and clinical practice to support the well-being of WLWH.
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Affiliation(s)
- Meghan C Jones
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA.
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Shorten
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Blvd, 35294-1210, Birmingham, AL, USA
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6
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de Pinho CSN, Santana RD, Campos EDM, Pires Neto RDJ. Prevalence and factors associated with depression in people living with HIV/AIDS in a Brazilian metropolitan region. AIDS Care 2022; 34:1580-1585. [PMID: 35862689 DOI: 10.1080/09540121.2022.2100866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA.
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Affiliation(s)
- Carolina Saraiva Nunes de Pinho
- Public Health Post-Graduation Program, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.,São José Hospital of Infectious Diseases, Fortaleza, Brasil
| | - Rafael Dantas Santana
- Division of Psychiatry, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brasil
| | - Eugênio de Moura Campos
- Division of Psychiatry, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brasil.,Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Roberto da Justa Pires Neto
- Public Health Post-Graduation Program, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.,São José Hospital of Infectious Diseases, Fortaleza, Brasil.,Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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7
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Okhai H, Sabin C, Haag K, Sherr L, Dhairyawan R, Shephard J, Richard G, Burns F, Post F, Jones R, Gilleece Y, Tariq S. The Prevalence and Patterns of Menopausal Symptoms in Women Living with HIV. AIDS Behav 2022; 26:3679-3687. [PMID: 35604509 PMCID: PMC9550775 DOI: 10.1007/s10461-022-03696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
Increasing numbers of women with HIV are experiencing menopause. We use data from a large, representative sample of women with HIV to describe the prevalence and clustering of menopausal symptoms amongst pre-, peri- and post-menopausal women using hierarchical agglomerative cluster analysis. Of the 709 women included, 21.6%, 44.9% and 33.6% were pre-, peri- and post-menopausal, respectively. Joint pain (66.4%) was the most commonly reported symptom, followed by hot flashes (63.0%), exhaustion (61.6%) and sleep problems (61.4%). All symptoms were reported more commonly by peri- and post-menopausal women compared to pre-menopausal women. Psychological symptoms and sleep problems clustered together at all menopausal stages. Somatic and urogenital symptom clusters emerged more distinctly at peri- and post-menopause. We recommend regular and proactive assessment of menopausal symptoms in midlife women with HIV, with an awareness of how particular patterns of symptoms may evolve over the menopausal transition.
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Affiliation(s)
- H Okhai
- Institute for Global health, University College London, London, UK.
| | - C Sabin
- Institute for Global health, University College London, London, UK
| | - K Haag
- Institute for Global health, University College London, London, UK
| | - L Sherr
- Institute for Global health, University College London, London, UK
| | - R Dhairyawan
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | | | - G Richard
- Institute for Global health, University College London, London, UK
| | - F Burns
- Institute for Global health, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - F Post
- Kings College Hospital NHS Foundation Trust, London, UK
| | - R Jones
- Chelsea and Westminster Healthcare NHS Foundation Trust, London, UK
| | - Y Gilleece
- Brighton & Sussex University Hospitals NHS Trust, Brighton, UK
- Brighton & Sussex Medical School, Brighton, UK
| | - S Tariq
- Institute for Global health, University College London, London, UK
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8
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Guan Y, Zhu H, Qi T, Zhang R, Chen J, Liu L, Shen Y, Lu H, Tang Q. HIV/AIDS strategies should focus on outcomes and the psychological status of older patients diagnosed with HIV. Biosci Trends 2021; 16:91-98. [PMID: 34732614 DOI: 10.5582/bst.2021.01437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In the context of an aging global population, the aging of patients with HIV is an issue that society will have to face. Data indicate that between 2011 and 2019, the proportion of patients age 60 and over who were newly diagnosed with HIV in China increased from 12% to 25%. In contrast to younger groups, the special characteristics of older patients pose major challenges to the management of their disease. The current study examined the clinical outcomes and psychological status of patients age 50 and over who were diagnosed with HIV. Out of a total of 566 older patients from eastern China, viral suppression was achieved in 446 (78.8%), treatment was immunologically effective in 410 (72.4%), and treatment was effective in 324 (57.2%). Thirty-nine patients (6.9%) had significant anxiety and 143 (25.3%) exhibited depressive tendencies. Level of education and the time from diagnosis to treatment were associated with the effectiveness of treatment. Age, sleep quality, chronic illness, exercise, and travel time to medical appointments were associated with depressive symptoms. These findings suggest that the burden of HIV among the older population remains high in more economically developed areas. The urgent need for HIV education and screening programs, as well as follow-up visits and early initiation of treatment in older patients, is called for.
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Affiliation(s)
- Yuan Guan
- Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Han Zhu
- Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tangkai Qi
- Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Renfang Zhang
- Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jun Chen
- Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Liu
- Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yinzhong Shen
- Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, China
| | - Qi Tang
- Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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9
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Danti R, Gayatri D. Relationship of psychological discomforts of stress, depression, and anxiety to sleep quality in HIV/AIDS patients. ENFERMERIA CLINICA 2021. [PMID: 33849216 DOI: 10.1016/j.enfcli.2020.09.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
HIV/AIDS remains a chronic disease that is ubiquitous in the community. People with HIV/AIDS can experience psychological problems because of the influence of internal and external stress. This study aimed to determine the relationship of psychological discomforts of stress, depression, and anxiety to sleep quality in HIV/AIDS patients. This study employed a descriptive-correlational research design with a cross-sectional approach and consecutive sampling technique. The Depression Anxiety Stress Scale-21 and Pittsburgh Sleep Quality Index were used as research instruments on 110 respondents. This study found that there was a significant relationship between psychological discomforts of stress, depression, and anxiety and sleep quality in patients with HIV/AIDS (p<α=0.05). The results of this study indicate the importance of health services, especially those of HIV/AIDS polyclinics, to be more concerned with the psychological discomfort experienced by patients to improve the sleep quality of patients with HIV/AIDS.
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Affiliation(s)
- Raden Danti
- Faculty of Nursing Universitas Indonesia, Depok, West Java, Indonesia
| | - Dewi Gayatri
- Faculty of Nursing Universitas Indonesia, Depok, West Java, Indonesia.
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10
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Bagheri Z, Noorshargh P, Shahsavar Z, Jafari P. Assessing the measurement invariance of the 10-item Centre for Epidemiological Studies Depression Scale and Beck Anxiety Inventory questionnaires across people living with HIV/AIDS and healthy people. BMC Psychol 2021; 9:42. [PMID: 33750473 PMCID: PMC7941965 DOI: 10.1186/s40359-021-00546-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Recently, extensive research has been reported the higher rate of depression and anxiety among people living with HIV/AIDS (PLWHAs) as compared to the general population. However, no single study has been carried out to investigate whether this disparity is a real difference or it happens due to lack of measurement invariance. This study aims to assess the measurement invariance of the Beck Anxiety Inventory (BAI) and 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) questionnaires across PLWHAs and healthy individuals. Methods One hundred and fifty PLWHAs and 500 healthy individuals filled out the Persian version of the BAI and CESD-10 questionnaires. Multi-group multiple-indicators multiple-causes model (MG-MIMIC) was used to assess measurement invariance across PLWHAs and healthy people. Results Our findings revealed that PLWHAs and healthy individuals perceived the meaning of all the items in the BAI and CESD-10 questionnaires similarly. In addition, although depression scores were significantly higher in PLWHAs as opposed to the healthy individuals, no significant difference was observed in anxiety scores of these two groups. Conclusions The current study suggests that the BAI and CESD-10 are invariant measures across PLWHAs and healthy people which can be used for meaningful cross-group comparison. Therefore, in comparison to healthy individuals, higher depression score of PLWHAs is a real difference. It is highly recommended that health professionals develop therapeutic interventions and psychological supports to promote the mental health of PLWHAs which alleviate their depressive symptoms.
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Affiliation(s)
- Zahra Bagheri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pegah Noorshargh
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shahsavar
- Department of English Language, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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11
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Mengistu N, Azale T, Yimer S, Fikreyesus M, Melaku E, Shumye S. Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu memorial hospital, 2018. SLEEP SCIENCE AND PRACTICE 2021. [DOI: 10.1186/s41606-020-00056-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness, it remains under-recognized and under-studied in Ethiopia. Therefore it is necessary to produce scientific evidence to fill the knowledge gap and areas of management. The current study aimed to assess sleep quality and its associated factors among people living with HIV/AIDS.
Methods
An institution-based cross-sectional study was utilized among 408 participants who were selected by a systematic random sampling technique at Zewditu memorial hospital from April to May 2018. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Ethical clearance was obtained from the joint ethics committee of the University of Gondar and Amanuel Mental Specialized Hospital. Oral informed consent was obtained from each participant. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI) was computed.
Results
The magnitude of poor sleep quality was 55.6%. Being female [AOR = 3.40, 95% CI: (1.80, 6.41)], depression [AOR =3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR = 3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR = 3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR = 5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR = 2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR = 3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality.
Conclusions
More than half of the study participants were found to have poor sleep quality. A range factors influence quality of sleep of people with HIV/AIDS. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.
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12
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Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study. J Psychiatr Res 2020; 126:134-140. [PMID: 31439359 DOI: 10.1016/j.jpsychires.2019.08.002] [Citation(s) in RCA: 551] [Impact Index Per Article: 137.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/03/2019] [Accepted: 08/08/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Depression is the most common mental illness worldwide. It has become an important public health problem. This study aimed to determine the global burden of depression and how it has changed between 1990 and 2017. METHODS We used information on depression obtained by the Global Burden of Disease (GBD) study from 1990 to 2017. The age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were used to assess the global burden of depression. RESULTS The number of incident cases of depression worldwide increased from 172 million in 1990 to 25,8 million in 2017, representing an increase of 49.86%. The ASR of depression varied widely between the 195 analyzed countries and regions in 2017, being highest in Lesotho (6.59 per 1000) and lowest in Myanmar (1.28 per 1000). The ASR increased the most between 1990 and 2017 in Belgium (EAPC = 0.88, 95% confidence interval [CI] = 0.78 to 0.97), and decreased the most in Cuba (EAPC = -1.26, 95% CI = -1.36 to -1.14). The ASR increased in regions with a high sociodemographic index, such as high-income North America (EAPC = 0.41, 95% CI = 0.31 to 0.51), and decreased significantly in South Asia (EAPC = -0.63, 95% CI = -0.85 to -0.41). The proportions of the population with major depressive disorder and dysthymia were essentially stable both globally and in various countries, with a much larger proportion having major depressive disorder. CONCLUSION Depression remains a major public health issue, and governments should support the research necessary to develop better prevention and treatment interventions.
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Affiliation(s)
- Qingqing Liu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jin Yang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaojie Feng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fanfan Zhao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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13
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Mengistu N, Belayneh Z, Shumye S. Knowledge, practice and correlates of sleep hygiene among people living with HIV/AIDS attending anti-retroviral therapy at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: a cross-sectional study. SLEEP SCIENCE AND PRACTICE 2020. [DOI: 10.1186/s41606-020-00044-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Sleep hygiene is a series of behavioral practices that can be performed by individuals with sleep complaints to prevent or reverse sleep difficulties. The feasibility, cost-effectiveness, absence of side effects and immediate responses to sleep problems make sleep hygiene practices more applicable than other treatment options for people living with HIV/AIDS. However, there is no evidence regarding sleep hygiene awareness and its practice in people with HIV/AIDS in Ethiopia.
Objectives
This study aimed to assess the knowledge, practice and correlates of sleep hygiene among adults attending outpatient anti-retroviral treatment at Zewditu Memorial Hospital.
Methods
This was an institutional based cross-sectional study conducted from 1st of May to 16th of June 2018 amongst people attending anti-retroviral therapy follow-up at Zewditu Memorial Hospital. Systematic random sampling technique was used to recruit a total of 396 study participants. Data were collected using interviewer-administered questionnaire. The Sleep Hygiene Index was used to measure the level of sleep hygiene of study participants. Binary logistic regression analysis was conducted to identify factors associated with sleep hygiene practice. In the multi-variable analysis, variables with P-values of less than 0.05 were considered as significant correlates of sleep hygiene practice with 95% confidence interval.
Results
The findings of this study showed that there are limitations regarding the knowledge and practice of sleep hygiene of people with HIV/AIDS in Ethiopia. None of the participants attended training regarding sleep hygiene. More than half (51.3%) had poor sleep hygiene practice. Female sex [AOR = 5.80:95% CI (3.12, 10.7)], being single [AOR =2.29:95% CI (0.13, 9.51)], depression [AOR = 2.93: 95% CI (1.73, 4.96)] and current khat use [AOR = 3.30; 95% CI (1.67, 6.50)] were identified as statistically significant correlates of poor sleep hygiene practice.
Conclusions
Knowledge regarding sleep hygiene is poor, and its practices are incorrect amongst people living with HIV/AIDS in Ethiopia. These findings demonstrate a need for professionals to play a major role in addressing this problem by integrating sleep hygiene as an added treatment modality to the HIV/AIDS care service. Designing training programs and awareness creation strategies for people with HIV/AIDS to improve their sleep hygiene practice is also highly recommended.
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McIntosh R, Antoni M, Seay J, Fletcher MA, Ironson G, Klimas N, Kumar M, Schneiderman N. Associations Among Trajectories of Sleep Disturbance, Depressive Symptomology and 24-Hour Urinary Cortisol in HIV+ Women Following a Stress Management Intervention. Behav Sleep Med 2019; 17:605-620. [PMID: 29461096 DOI: 10.1080/15402002.2018.1435545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: The burden of sleep disturbance and depressive symptomology is high for persons living with HIV and particularly so for women. While cognitive behavioral stress management (CBSM) is shown to reduce symptoms of depression and 24-hr urinary free cortisol output (CORT) in HIV+ men, less is known about the effects of CBSM on mood and concomitant sleep disturbance in HIV+ women. The study aim is to model longitudinal change in sleep disturbance, depressive symptomology, and CORT for HIV+ women exposed to a 12-week CBSM intervention or control condition. Methods: Self-reported sleep quality and depressive symptomology, along with CORT, was collected from surveys at baseline and approximately every three months thereafter for nine months from 130 HIV+ women (Mage = 38.44, SD = 7.73). The data was used to specify a parallel process latent growth model with CORT as a time-varying covariate. Results: The model showed acceptable fit. There was a linear decline in sleep disturbance (β = -0.32, p < .05) and logarithmic decline in depressive symptomology (β = -0.33, p < .05) for those receiving the intervention. Decline in sleep disturbance predicted lower CORT at nine months. Furthermore, having less depressive symptoms at baseline was associated with lower initial levels of sleep disturbance and greater improvement in sleep quality over time. There was no discernible association between sleep and mood disturbance in the control group. Across groups, there was a consistent association between older age and greater sleep disturbance (r = 0.34, p < .01). Conclusion: Sleep disturbance appears to be a behavioral target for CBSM in HIV+ women although older age, preintervention levels of depressive mood, and time-varying levels of CORT output may limit improvement in sleep quality over time.
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Affiliation(s)
- Roger McIntosh
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA
| | - Michael Antoni
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA.,b Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami , Miami , Florida , USA.,e Departments of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Julia Seay
- b Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami , Miami , Florida , USA
| | - Mary Ann Fletcher
- c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,d Institute for Neuro-immune Medicine, Nova Southeastern University , Davie , Florida , USA
| | - Gail Ironson
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA
| | - Nancy Klimas
- c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,d Institute for Neuro-immune Medicine, Nova Southeastern University , Davie , Florida , USA
| | - Mahendra Kumar
- e Departments of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Neil Schneiderman
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA.,c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,f Behavioral Medicine Research Center, Miller School of Medicine, University of Miami , Miami , Florida , USA
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15
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Gutierrez J, Tedaldi EM, Armon C, Patel V, Hart R, Buchacz K. Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea. SAGE Open Med 2019; 7:2050312119842268. [PMID: 31001423 PMCID: PMC6454647 DOI: 10.1177/2050312119842268] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/05/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate sleep disturbances in a diverse, contemporary HIV-positive patient cohort and to identify demographic, clinical, and immune correlates. METHODS A convenience sample of 176 patients from a racially and ethnically diverse HIV-positive patient cohort in an urban population. This was a cross-sectional, epidemiologic study. We surveyed participants using multiple standardized instruments to assess depression, sleep quality, and risk for sleep apnea. We analyzed demographic, behavioral, and clinical correlates. RESULTS A total of 56% of participants were female, 75% Black and 64% had heterosexual HIV risk. The median age was 49 years. Poor sleep quality (Pittsburgh Sleep Quality Index > 5) was reported by 73% of patients and 52% met insomnia diagnosis criteria. A single question about self-reported sleep problems predicted a Pittsburgh Sleep Quality Index > 5 with a sensitivity and specificity of 82% and 81%, respectively. Female sex was significantly associated with higher risk of poor sleep quality, depression, and insomnia, whereas higher risk of obstructive sleep apnea was significantly associated with older age, male sex, obesity (body mass index ⩾ 30 kg/m2), and metabolic comorbidities. High risk for obstructive sleep apnea, high rate of depression, and poor sleep hygiene represent treatment targets for sleep problems in HIV patients. CONCLUSION Sleep disturbances were common in this patient cohort, although largely undiagnosed and untreated. Sleep problems are linked to worse disease progression and increased cardiovascular mortality. Screening for sleep problems with a single question had high sensitivity and specificity. In those patients with self-reported sleep problems, screening for obstructive sleep apnea, depression, and sleep hygiene habits should be part of routine HIV care.
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Affiliation(s)
- Jeydith Gutierrez
- Department of Internal Medicine,
University of Iowa Hospitals and Clinics and The Roy J. and Lucille A. Carver
College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Ellen M Tedaldi
- Section of General Internal Medicine,
Department of Medicine, Lewis Katz School of Medicine, Temple University,
Philadelphia, PA, USA
| | - Carl Armon
- Cerner Corporation, Kansas City, MO,
USA
| | - Vaidahi Patel
- Section of General Internal Medicine,
Department of Medicine, Lewis Katz School of Medicine, Temple University,
Philadelphia, PA, USA
| | | | - Kate Buchacz
- Division of HIV/AIDS Prevention, Centers
for Disease Control and Prevention, Atlanta, GA, USA
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16
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Redman KN, Karstaedt AS, Scheuermaier K. Increased CD4 counts, pain and depression are correlates of lower sleep quality in treated HIV positive patients with low baseline CD4 counts. Brain Behav Immun 2018; 69:548-555. [PMID: 29452219 DOI: 10.1016/j.bbi.2018.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/12/2018] [Accepted: 02/12/2018] [Indexed: 12/17/2022] Open
Abstract
Poor sleep quality leads to increased immune activation and immune activation leads to worse sleep quality. South African HIV positive patients typically have delayed start of treatment, which has been associated with CD4+ effector T cells being more spontaneously activated in chronically treated patients. This cross-sectional study investigated whether subjective sleep quality was associated with CD4+ T lymphocyte reconstitution in treated South African HIV+ patients. One hundred and thirty-nine treated HIV+ patients (109 F, age average (SD) = 43 (9)) were recruited from Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa. Participants completed questionnaires evaluating their subjective sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth sleepiness scale), pain, and depression severity (Beck Depression Inventory). Univariate and multivariate analyses were run to determine the correlates of sleep quality in this population. Patients had been on antiretroviral treatment for about 4 years and had increased their CD4 counts from a median at baseline of 82 to 467 cells/µL. They had overall poor sleep quality (average (SD) PSQI = 7.7 (±5), 61% reporting PSQI > 5, a marker of lower sleep quality), 41% had clinical depression (average (SD) BDI = 17 (±12)) and 55% reported pain. In two separate multivariate analyses, both the overall CD4 count increase from baseline (p = 0.0006) and higher current CD4 counts (p = 0.0007) were associated with worse sleep quality, when adjusting for depression severity (p < 0.001), daytime sleepiness (p = 0.01) and the presence of pain (p < 0.01). In this cohort of treated South African HIV positive patients, poor sleep quality was associated with higher current CD4 counts, when adjusting for depression severity, daytime sleepiness and pain. Further studies should investigate the temporal relationship between HIV-related poor sleep quality and underlying immune activation.
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Affiliation(s)
- K N Redman
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - A S Karstaedt
- Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - K Scheuermaier
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
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17
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Doosti-Irani A, Moameri H, Ahmadi-Gharaei H, Holakouie-Naieni K. Prevalence of depression in people with HIV and AIDS in Iran: A systematic review. Med J Islam Repub Iran 2017; 31:75. [PMID: 29445704 PMCID: PMC5804452 DOI: 10.14196/mjiri.31.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Depression is the most common mental disorder in individuals with HIV and AIDS (PLWHA), and comorbidity with depression exacerbates the disease. Several studies have estimated the prevalence of depression in HIV and AIDS patients so far, but there is no consensus about the prevalence of depression among these patients. Thus, we aimed at estimating the overall prevalence of depression among Iranian PLWHA. Methods: The international and national databases including Web of Science, Scopus, Medline, Science Direct, MagIran, Scientific Information Database (SID), IranMedex, and Medlib were searched until June 2016. The quality of included studies was assessed using Newcastle-Ottawa Scale. Results: Out of 591 references, 9 cross-sectional studies met the eligibility criteria and were included in the review. The lowest and highest reported prevalence of depression among people with HIV was 22% (95% CI: (11, 33)) and 76% (95% CI: (71, 81)), respectively. Prevalence of depression in people with HIV in the north, west, and south of Iran was 45% (95% CI: (23, 67)), 30% (95% CI: (15, 45)), and 56% (95% CI: (35, 77)), respectively. Prevalence of depression among addict and non-addict patients was 25% (95% CI: (21, 30)) and 58% (95% CI: (40, 77)), respectively. Conclusion: According to the results of this systematic review, the prevalence of depression is considerable among Iranian PLWHA. Prevalence in the southern regions of Iran is more than the western and northern regions of Iran. This evidence may be useful for Iranian health policymakers to design suitable preventive and therapeutic interventions in PLWHA to prevent and control depression among these people in Iran.
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Affiliation(s)
- Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Moameri
- Department of Epidemiology and biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Ahmadi-Gharaei
- Department of Epidemiology and biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Huang X, Li H, Meyers K, Xia W, Meng Z, Li C, Bai J, He S, Cai W, Huang C, Liu S, Wang H, Ling X, Ma P, Tan D, Wang F, Ruan L, Zhao H, Wei H, Liu Y, Yu J, Lu H, Wang M, Zhang T, Chen H, Wu H. Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China. Sci Rep 2017. [PMID: 28623361 PMCID: PMC5473875 DOI: 10.1038/s41598-017-03968-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44–4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70–2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86–7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04–1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21–1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03–1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23–1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12–3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47–2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.
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Affiliation(s)
- Xiaojie Huang
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China
| | - Huiqin Li
- Infectious Diseases Department, Yunnan AIDS Caring Center, Kunming, Yunnan, 650301, China
| | - Kathrine Meyers
- The Aaron Diamond AIDS Research Center, New York, NY, 10016, United States
| | - Wei Xia
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China
| | - Zhihao Meng
- Infectious Diseases Department, Longtan Hospital of Guangxi, Liuzhou, Guangxi, 545005, China
| | - Chongxi Li
- Infectious Diseases Department, the Third People's Hospital of Kunming, Kunming, Yunnan, 650041, China
| | - Jinsong Bai
- Infectious Diseases Department, the Third People's Hospital of Kunming, Kunming, Yunnan, 650041, China
| | - Shenghua He
- Infectious Diseases Department, the Infectious Diseases Hospital of Chengdu, Chengdu, Sichuan, 610061, China
| | - Weiping Cai
- Institute of Infectious Diseases, the Eighth People's Hospital of Guangzhou, Guangzhou, Guangdong, 510060, China
| | - Chengyu Huang
- Department of AIDS, Chongqing Infectious Disease Medical Center, Chongqing, 400039, China
| | - Shuiqing Liu
- Department of Infectious Diseases, the Fifth People's Hospital of Guiyang, Guiyang, Guizhou, 550004, China
| | - Hui Wang
- Department of Clinical AIDS Research, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, 518020, China
| | - Xuemei Ling
- Department of Hematology, the Third People's Hospital of Hengyang, Hengyang, Hunan, 421000, China
| | - Ping Ma
- Department of Infectious Diseases, the Second People's Hospital of Tianjin, Tianjin, 300193, China
| | - Daling Tan
- Department of Infectious Diseases, the People's Hospital of Luzhai, Liuzhou, Guangxi, 545600, China
| | - Fuxiang Wang
- Department of Infectious Diseases, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Lianguo Ruan
- Department of Infectious Diseases, Wuhan Medical Treatment Center, Wuhan, Hubei, 430023, China
| | - Hongxin Zhao
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Hongxia Wei
- Department of Infectious Diseases, the Second Hospital of Nanjing Affiliated to Southeast University Medical College, Nanjing, Jiangsu, 210003, China
| | - Yanfen Liu
- Department of Infectious Diseases, the Fourth People's Hospital of Nanning, Nanning, Guangxi, 530023, China
| | - Jianhua Yu
- Department of Infectious Diseases, the Sixth People's Hospital of Hangzhou, Hangzhou, Jiangsu, 310023, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, 200083, China
| | - Min Wang
- Department of Infectious Diseases, the First People's Hospital of Changsha, Changsha, Hunan, 410005, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China
| | - Hui Chen
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.
| | - Hao Wu
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China.
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Elbadawi A, Mirghani H. Depression among HIV/AIDS Sudanese patients: a cross-sectional analytic study. Pan Afr Med J 2017; 26:43. [PMID: 28451021 PMCID: PMC5398233 DOI: 10.11604/pamj.2017.26.43.10919] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/22/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Depression and HIV/AIDS are common morbid health problems; the relationship is bidirectional exacerbating each other with deleterious consequences. There are limited studies on this topic in Sudan. In this study, we investigated depression among HIV/AIDS in Sudan. Methods A cross-sectional analytic study was conducted among 362 HIV/AIDS patients from three centers in Khartoum, Sudan. Data were collected by the Hospital Depression and Anxiety (HADS) questionnaire. Chi-square was used for testing the significance and a P. Value of ≥ 0.05 was considered as statistically significant. Results Depression was evident in 332 (63.1%) of patients 68 (19.3%) had mild depression, 114 (32.4%) moderate depression, and 40 (11.4%) severe depression. Depression was commoner among women, illiterate, married/widowed, not receiving counseling, delaying the result of the test, P-value <0.05, no significant differences were found regarding test and treatment type P- Value >0.05. Conclusion Depression was prevalent among HIV/AIDS patients, especially females, low level of education, and widowed/married patients, and those not receiving counseling and post diagnosis sessions.
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Affiliation(s)
- Abdulateef Elbadawi
- Community Medicine Department, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Hyder Mirghani
- Medical Department, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
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Reis RK, Castrighini CDC, Melo ES, Jesus GJD, Queiroz AAFL, Gir E. Avaliação dos sintomas depressivos somáticos e afetivo-cognitivos de pessoas vivendo com HIV/AIDS. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Resumo Objetivo Analisar os sintomas somáticos e afetivo-cognitivos de depressão segundo o sexo de pessoas que vivem com HIV/AIDS. Métodos Estudo analítico realizado em serviços de atendimento especializado em Ribeirão Preto-SP, com amostra de 331 participantes. Para coleta de dados foram utilizados instrumento de caracterização sociodemográfica e o Inventário de Depressão de Beck (BDI). Resultados Dos entrevistados, 50,4% eram do sexo masculino e destes, 52,1% estavam na faixa etária de 20 a 35 anos. As mulheres apresentaram maior escolaridade (p=0,001) e menor renda (<0,001), e os homens apresentaram mais comorbidades (p=0,004). Identificou-se que as mulheres apresentaram maiores médias de escores de depressão, tanto no domínio somático (p<0,001) quanto no afetivo/cognitivo (p<0,001). Conclusão Os resultados deste estudo apontam que as mulheres apresentam maiores escores de sintomatologia depressiva do que os homens, tanto no domínio somático quanto no afetivo/cognitivo das subescalas do IDB.
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21
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Tello-Velásquez JR, Díaz-Llanes BE, Mezones-Holguín E, Rodríguez-Morales AJ, Huamaní C, Hernández AV, Arévalo-Abanto J. [Poor quality of sleep associated with low adherence to highly active antiretroviral therapy in Peruvian patients with HIV/AIDS]. CAD SAUDE PUBLICA 2015; 31:989-1002. [PMID: 26083174 DOI: 10.1590/0102-311x00010014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 12/01/2014] [Indexed: 01/25/2023] Open
Abstract
This cross-sectional study analyzed the association between poor quality of sleep and adherence to highly active antiretroviral therapy (HAART) in 389 Peruvian patients with HIV/AIDS. Poor quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI) and adherence with the CEAT-VIH (Peruvian adaptation). A Poisson generalized linear model with robust standard errors was used to estimate prevalence ratios and 95%CI. A crude model showed that mild, moderate, and severe poor quality of sleep were associated with inadequate treatment adherence. In the adjusted model for variables associated in the bivariate analysis or variables theoretically associated with adherence, only moderate/severe poor quality of sleep remained associated (PR = 1.34, 95%CI: 1.17-1.54; and PR = 1.34, 95%CI: 1.16-1.57, respectively). The study concluded that moderate/severe poor quality of sleep was independently associated with adherence to HAART. Assessing quality of sleep may be helpful in the comprehensive evaluation of HIV patients.
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Affiliation(s)
| | | | | | | | - Charles Huamaní
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
| | - Adrián V Hernández
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
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Wu J, Wu H, Lu C, Guo L, Li P. Self-reported sleep disturbances in HIV-infected people: a meta-analysis of prevalence and moderators. Sleep Med 2015; 16:901-7. [PMID: 26188954 DOI: 10.1016/j.sleep.2015.03.027] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/03/2015] [Accepted: 03/30/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Our goal was to estimate the pooled prevalence of self-reported sleep disturbances in HIV-infected people through meta-analysis, taking into account variations in geographic region, gender, age group, CD4 counts, and instrument used to measure sleep disturbances. METHODS The authors conducted systematic searches of PubMed and PsycINFO to include studies that met our criteria. A random effect meta-analysis model was used to estimate the pooled prevalence of self-reported sleep disturbances in HIV-infected people. The potential moderators of self-reported sleep disturbances were explored with meta-regression analysis. RESULTS Twenty-seven articles comprising a total of 9246 HIV-positive participants were finally included in our analysis. The overall prevalence of self-reported sleep disturbances in HIV-infected people was 58.0% (95% CI = 49.6-66.1). Meta-regression analysis indicates that geographic region, gender, and instrument significantly explain part of the heterogeneity of the prevalence estimates between the included studies. CONCLUSION The findings suggest that HIV-infected people suffer from a heavy burden of sleep disturbances. It is therefore recommended that sleep quality should be routinely assessed in HIV-infected people in order to identify the medical treatment needs and the potential impact of sleep problems on antiretroviral therapy outcomes in this population.
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Affiliation(s)
- Jie Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Hong Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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Oshinaike O, Akinbami A, Ojelabi O, Dada A, Dosunmu A, John Olabode S. Quality of Sleep in an HIV Population on Antiretroviral Therapy at an Urban Tertiary Centre in Lagos, Nigeria. Neurol Res Int 2014; 2014:298703. [PMID: 24876959 PMCID: PMC4020213 DOI: 10.1155/2014/298703] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/23/2014] [Accepted: 04/07/2014] [Indexed: 01/26/2023] Open
Abstract
Aim. To determine the prevalence of sleep disturbance and its associated characteristics in HIV-positive outpatients on HAART using the PSQI. Methods. Using a cross-sectional design, 300 patients attending the outpatient HIV/AIDS clinic at the Lagos State University Teaching Hospital were recruited. Baseline data obtained included the participants' demographic data, educational qualification, and marital status. Their treatment history, including duration since HIV diagnosis, the most recent CD4 cell count, and current antiretroviral therapies, was obtained from their case records. Each participant completed the PSQI questionnaire and those with scores ≥5 were diagnosed with poor sleep quality. Results. The participants were made up of 70.7% females and 29.3% males. Their ages ranged between 18 and 74 years with a mean of 38.9 ± 10.3 years. According to the PSQI, 59.3% reported poor sleep quality. The mean score of those with poor quality sleep (9.2 ± 3.3) was comparable to that of those with good quality sleep (1.26 ± 1.4). P < 0.001. Significant differences were observed in all the individual components of the PSQI (P < 0.001). On multivariate analyses, the independent associations with sleep quality were the duration since HIV diagnosis (P = 0.29), efavirenz based regimen (P < 0.001), and lower CD4 cell count (P < 0.001). Conclusions. Sleep disturbances are quite common in the HIV population even in the era of HAART. Early recognition via routine assessment and effective treatments could prevent the resultant complications and improve quality of life.
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Affiliation(s)
- Olajumoke Oshinaike
- Department of Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Akinsegun Akinbami
- Department of Haematology and Blood Transfusion, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olaitan Ojelabi
- Department of Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Akinola Dada
- Department of Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Adedoyin Dosunmu
- Department of Haematology and Blood Transfusion, Lagos State University College of Medicine, Lagos, Nigeria
| | - Sarah John Olabode
- Department of Hematology, Ben Carson College of Medicine, Babcock University, Ogun, Nigeria
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Seda G, Lee-Chiong T, Harrington J. Sleep Derangements in Central Nervous System Infections. Sleep Med Clin 2012. [DOI: 10.1016/j.jsmc.2012.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ferreira LTK, Ceolim MF. Qualidade do sono em portadores do vírus da imunodeficiência humana. Rev Esc Enferm USP 2012; 46:892-9. [DOI: 10.1590/s0080-62342012000400016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 11/26/2011] [Indexed: 11/21/2022] Open
Abstract
Este estudo teve por objetivo caracterizar a qualidade do sono de pessoas com o vírus da imunodeficiência humana (HIV) - AIDS - , com ou sem manifestações clínicas e sob tratamento ambulatorial. Para tal, foi realizada pesquisa descritiva e transversal. Os instrumentos utilizados foram: Questionário de Caracterização Sociodemográfica e Clínica; Índice de Qualidade de Sono de Pittsburgh (PSQI-BR). Participaram da pesquisa 122 pacientes (55,7% de homens e 44,3% de mulheres, com idade média de 42,3 (± 8,9 anos), dos quais 53,3% referiram apresentar sono de boa qualidade e 46,7%, sono de má qualidade. Dormiam, em média, 7,3 (± 1,8) horas, com latência de 23,2 (± 26,2) minutos e eficiência do sono de 87,8% (± 14,4). Observou-se associação significativa entre o sono de boa qualidade e os seguintes fatores: ter companheiro(a); apresentar carga viral indetectável; manter comportamento de risco. Recomenda-se que os profissionais de enfermagem incluam sistematicamente questões sobre o sono ao avaliarem o paciente com HIV/AIDS, detectando alterações precocemente e reunindo subsídios para o planejamento de intervenções.
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Low Y, Goforth HW, Omonuwa T, Preud'homme X, Edinger J, Krystal A. Comparison of polysomnographic data in age-, sex- and Axis I psychiatric diagnosis matched HIV-seropositive and HIV-seronegative insomnia patients. Clin Neurophysiol 2012; 123:2402-5. [PMID: 22727712 DOI: 10.1016/j.clinph.2012.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 04/12/2012] [Accepted: 05/07/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE There is a high prevalence of insomnia in HIV-seropositive patients. Insomnia is associated with poorer disease outcomes, cognitive impairment and HIV-associated dementia. However there is limited data characterizing the type of sleep disturbances, and the cause. Previous studies report conflicting results, and observed changes in the distribution of REM and SWS were hypothesized to result from co-morbid mood disorders, although this is not established. We carried out this study to determine if there are differences in polysomnographic (PSG) sleep data in age-, sex- and Axis I diagnoses- matched HIV-seropositive and HIV-seronegative patients. METHODS Eighteen HIV-seropositive insomniacs were matched to HIV-seronegative insomniacs based on age, sex and Axis I diagnoses. Participants spent 2 consecutive nights in a sleep lab recording of PSG data. RESULTS Multivariate analysis revealed an overall significant match-by-variable interaction (p=0.0126). Follow-up analysis show that compared to HIV-seronegative insomnia controls, HIV-seropositive insomniacs have significantly longer SOL, 8% decreased sleep efficiency, and 8-10% decreased time spent in REM sleep (p's<0.05). CONCLUSION This study provides preliminary evidence that even after accounting for differences in age, sex and psychiatric diagnoses, HIV-seropositive patients with insomnia have significantly worse sleep than HIV-seronegative patients with insomnia. SIGNIFICANCE Unlike what previous authors have proposed, our results do not support the view that comorbid psychiatric disorders like depression are responsible for the observed differences in PSG findings and the greater incidence of insomnia, in HIV-seropositive patients when compared with other groups of insomnia patients. This suggests the presence of other etiologies including neuronal damage, psychosocial stressors, or comorbid medical conditions. Further studies are needed to determine the extent to which these play a role in insomnia in the HIV-seropositive population.
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Affiliation(s)
- Yinghui Low
- Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
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Low Y, Preud'homme X, Goforth HW, Omonuwa T, Krystal AD. The association of fatigue with depression and insomnia in HIV-seropositive patients: a pilot study. Sleep 2011; 34:1723-6. [PMID: 22131611 DOI: 10.5665/sleep.1446] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Fatigue is a pervasive symptom associated with HIV, resulting in significant functioning impairment; but little is known about its etiology or treatment. In patients with primary insomnia, data have shown improvement in fatigue following successful treatment of insomnia. However, little is known about the role of insomnia in patients with fatigue in HIV. This manuscript seeks to test the hypothesis that insomnia severity is correlated with increased fatigue in HIV-seropositive patients. METHODS Fifty-seven ambulatory HIV-seropositive patients, aged 18-60 years, with a DSM-IV-TR diagnosis of insomnia, were administered the Insomnia Severity Index (ISI), Piper Fatigue Scale (PFS), Hospital Anxiety and Depression scale, and Hamilton Depression Rating Scale (HAM-D). Their most recent CD4 count and time since diagnosis of HIV were recorded. Regression analysis was carried out with PFS as the dependent variable. RESULTS A higher ISI score correlated with higher PFS score, (R2 = 0.1713, P = 0.0042). Overall depression severity was not significantly correlated with PFS score, except in the most severely depressed subgroup, in which the HADS depression score was the strongest predictor of PFS (R2 = 0.182, P = 0.0009). In participants without depression, ISI accounted for most of the variance in fatigue (R2 = 0.6035, P = 0.0011). CONCLUSIONS Greater insomnia severity is associated with greater fatigue severity in HIV seropositive patients. Depression may contribute to both fatigue and insomnia. In the absence of depression, the treatment of insomnia may emerge as a treatment strategy to help alleviate fatigue. Further studies are needed to confirm these data. CLINICAL TRIAL INFORMATION Clinical Trials.Gov: The Treatment of Insomnia in Patients with HIV Disease. Registry Number: NCT00465972. URL: http://www.clinicaltrials.gov/ct2/show/NCT00465972?term = HIV+insomnia&rank = 1.
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Affiliation(s)
- Yinghui Low
- Duke-National University of Singapore School of Medicine
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