Yi Michael S, Mrus Joseph M, Wade Terrance J, Ho Mona L, Hornung Richard W, Cotton Sian, Peterman Amy H, Puchalski Christina M, Tsevat Joel
Division of General Internal Medicine, Section of Outcomes Research, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267-0535, USA.
J Gen Intern Med. 2006 Dec;21 Suppl 5(Suppl 5):S21-7. doi: 10.1111/j.1525-1497.2006.00643.x.
Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well-being has been linked to increased risk for depression and other mood disorders in patients with HIV.
We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi-center cohort of patients with HIV/AIDS.
Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale. Independent variables included socio-demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self-esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms.
We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty-one (53.6%) fit the criteria for significant depressive symptoms (CESD-10 score > or = 10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV-related symptoms, less social support, and lower spiritual well-being was associated with significant depressive symptoms (P<.05).
A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well-being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.
抑郁症与慢性病患者的免疫功能及死亡率相关。精神健康状况较差等因素与感染艾滋病毒患者患抑郁症及其他情绪障碍的风险增加有关。
我们试图确定宗教、精神信仰的具体维度以及其他因素如何与当代多中心艾滋病毒/艾滋病患者队列中的抑郁症状相关。
2002年至2003年从3个城市的4个医疗中心招募患者，由经过培训的访员发放问卷。采用10项流行病学研究中心抑郁量表（CESD - 10）测量抑郁症状水平。自变量包括社会人口统计学、临床信息、健康状况及担忧的8个维度、症状、社会支持、风险态度、自尊、精神信仰、宗教归属、宗教虔诚度及宗教应对方式。我们研究了宗教虔诚度、精神信仰与抑郁症状的双变量及多变量关联。
我们收集了450名受试者的数据。他们的平均（标准差）年龄为43.8（8.4）岁；387名（86.0%）为男性；204名（45.3%）为白人；他们的平均CD4细胞计数为420.5（301.0）。241名（53.6%）符合显著抑郁症状标准（CESD - 10评分≥10）。在多变量分析中，健康担忧较多、对感染艾滋病毒的方式不太释怀、艾滋病毒相关症状较多、社会支持较少以及精神健康状况较差与显著抑郁症状相关（P<0.05）。
大多数艾滋病毒患者报告有显著抑郁症状。健康状况及认知较差、社会支持较少以及精神健康状况较差与显著抑郁症状相关，而在控制其他因素时，个人宗教虔诚度及宗教归属与之无关。在医疗或社区环境中帮助满足患者的精神需求可能是减少艾滋病毒/艾滋病患者抑郁症状的一种方法。
