Berger-Greenstein Jori A, Cuevas Carlos A, Brady Stephen M, Trezza Glenn, Richardson Mark A, Keane Terence M
Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
AIDS Patient Care STDS. 2007 Dec;21(12):942-55. doi: 10.1089/apc.2006.0153.
Previous research has been inconsistent in documenting a strong relationship between depression and HIV/AIDS, although a recent meta-analysis of studies examining this issue indicates that rates of depression are modestly higher for this population. For the current study, conducted from 2001-2004, we sought to examine rates and types of depressive symptoms in a cohort of patients receiving HIV care at two urban medical centers. These patients were participants in an intervention study examining adherence and mental health in persons triply diagnosed with psychiatric disorders, substance use disorders, and HIV/AIDS. Nearly three quarters of these participants were people of color, two thirds described their sexual orientation as heterosexual, and the vast majority were unemployed. We sought to examine the relationship of depression to patients' adherence to antiretroviral medication regimens (highly active antiretroviral therapy [HAART]). Results obtained from structured clinical interviews and self-report questionnaires indicated that study participants experienced high rates of depressive symptoms, and that 72.9% of participants met criteria for major depressive disorder (MDD). The results of this study offer a detailed view of the incidence and nature of MDDs and depressive symptoms for an urban sample of substance-abusing adults with HIV/AIDS. Given the degree to which depressive symptoms and MDD appear to be prevalent for this group, as well as the observation that these symptoms are amenable to treatment, future research should focus on identifying helpful strategies and interventions for treating these symptoms, effective ways of providing linkages to care, and ways in which standardized assessment and treatment protocols might be adapted to better suit this population.
先前的研究在记录抑郁症与艾滋病毒/艾滋病之间的紧密关系方面一直存在不一致之处，尽管最近一项针对该问题的研究的荟萃分析表明，这一人群的抑郁症发病率略高。在2001年至2004年进行的这项当前研究中，我们试图调查在两个城市医疗中心接受艾滋病毒治疗的一组患者中抑郁症状的发生率和类型。这些患者是一项干预研究的参与者，该研究考察了被三重诊断为精神疾病、物质使用障碍和艾滋病毒/艾滋病的患者的依从性和心理健康状况。这些参与者中近四分之三是有色人种，三分之二称自己的性取向为异性恋，绝大多数人失业。我们试图研究抑郁症与患者对抗逆转录病毒药物治疗方案（高效抗逆转录病毒治疗[HAART]）的依从性之间的关系。从结构化临床访谈和自我报告问卷中获得的结果表明，研究参与者经历了高比例的抑郁症状，并且72.9%的参与者符合重度抑郁症（MDD）的标准。这项研究的结果详细呈现了患有艾滋病毒/艾滋病的城市滥用药物成年样本中重度抑郁症和抑郁症状的发生率及性质。鉴于抑郁症状和重度抑郁症在该群体中似乎很普遍，以及这些症状可通过治疗改善这一观察结果，未来的研究应侧重于确定治疗这些症状的有益策略和干预措施、提供护理联系的有效方式，以及标准化评估和治疗方案如何可能进行调整以更好地适合这一人群。
