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人类免疫缺陷病毒/艾滋病(HIV/AIDS)患者抑郁症的本质。

Nature of depression in patients with HIV/AIDS.

作者信息

Judd Fiona, Komiti Angela, Chua Phyllis, Mijch Anne, Hoy Jennifer, Grech Paul, Street Alan, Lloyd John, Williams Ben

机构信息

Centre for Rural Mental Health, School of Psychiatry, Psychology and Psychological Medicine, Monash University, PO Box 126, Bendigo, Victoria 3552, Australia.

出版信息

Aust N Z J Psychiatry. 2005 Sep;39(9):826-32. doi: 10.1080/j.1440-1614.2005.01659.x.

Abstract

OBJECTIVE

Existing research suggests that the rate of depressive illness and depressive symptoms are high in people living with HIV/AIDS, but investigations on the causes of depression provide conflicting results. Social, psychological and biological factors have all been suggested as possible causes of depression in people living with HIV/AIDS. The suggestion that depression may be the result of the neurotropic effects of the virus on the central nervous system leading to an 'organic' or secondary depression has major implications in the treatment of HIV/AIDS. The aim of the current study was to further investigate the nature and underlying aetiology of depression in people living with HIV/AIDS.

METHOD

One hundred and twenty-nine people living with HIV/AIDS recruited for the study from outpatients clinics and primary care settings completed a range of self-report symptom measures including the Beck Depression Inventory (BDI), SF-36, SPHERE and a personality measure, the NEO Personality Inventory (NEO-PI). They also completed a battery of neuropsychological tests (CANTAB) and a structured clinical interview (SCID-DSM-IV). Medical and sociodemographic data were also recorded.

RESULTS

Approximately one-third scored > or = 14 on the BDI and 27% met criteria for a current 'mood disorder' on the SCID. Depressive symptoms were strongly related to personality style, having a past psychiatric history and current stressful psychosocial situation. There was no association between depression and HIV disease status. There was no evidence in this study cohort of a distinct subtype of 'organic' or secondary depression.

CONCLUSIONS

These results suggest that at least for 'well' people living with HIV/AIDS, there is no distinct subtype of depression and early treatment approaches can be modelled on those used for other non-HIV groups. Further longitudinal studies will be required to dissect out the multiple factors underlying depression in HIV/AIDS.

摘要

目的

现有研究表明,感染艾滋病毒/艾滋病的人群中抑郁症及抑郁症状的发生率较高,但关于抑郁症病因的调查结果相互矛盾。社会、心理和生物学因素均被认为可能是艾滋病毒/艾滋病感染者患抑郁症的原因。抑郁症可能是病毒对中枢神经系统的神经otropic作用导致“器质性”或继发性抑郁症的这一观点,对艾滋病毒/艾滋病的治疗具有重要意义。本研究的目的是进一步调查艾滋病毒/艾滋病感染者抑郁症的性质和潜在病因。

方法

从门诊诊所和初级保健机构招募的129名艾滋病毒/艾滋病感染者完成了一系列自我报告症状测量,包括贝克抑郁量表(BDI)、SF-36、SPHERE以及一项人格测量工具,即大五人格量表(NEO-PI)。他们还完成了一系列神经心理学测试(CANTAB)和结构化临床访谈(SCID-DSM-IV)。同时记录了医疗和社会人口统计学数据。

结果

约三分之一的人在BDI上得分≥14,27%的人在SCID上符合当前“情绪障碍”的标准。抑郁症状与人格类型、有既往精神病史以及当前紧张的心理社会状况密切相关。抑郁症与艾滋病毒疾病状态之间没有关联。在本研究队列中,没有证据表明存在一种独特的“器质性”或继发性抑郁症亚型。

结论

这些结果表明,至少对于“病情稳定”的艾滋病毒/艾滋病感染者来说,不存在独特的抑郁症亚型,早期治疗方法可以借鉴用于其他非艾滋病毒感染群体的方法。需要进一步进行纵向研究,以剖析艾滋病毒/艾滋病患者抑郁症背后的多种因素。

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