Vranceanu Ana Maria, Safren Steven A, Lu Minyi, Coady William M, Skolnik Paul R, Rogers William H, Wilson Ira B
Department of Psychology, Massachusetts General Hospital, Harvard Medical School, and the Fenway Community Health Center, Boston, Massachusetts, USA.
AIDS Patient Care STDS. 2008 Apr;22(4):313-21. doi: 10.1089/apc.2007.0069.
In HIV/AIDS, symptoms of depression or post-traumatic stress may interfere with important self-care behaviors such as the ability to adhere to one's medical treatment regimen. However, these problems may frequently go undetected in HIV care settings. The present study used brief self-report screening measures of depression and post-traumatic stress disorder (PTSD) in the HIV/AIDS care settings to examine (1) frequency of positive screens for these diagnoses; (2) the degree to which those with a positive screen were prescribed antidepressant treatment; and (3) the association of continuous PTSD and depression symptom scores, and categorical (screening positive or negative) PTSD and depression screening status, to each other and to ART adherence as assessed by the Medication Event Monitoring System, regardless of antidepressant treatment. Participants were 164 HIV-infected individuals who took part in a multisite adherence intervention study in HIV treatment settings in Massachusetts. Available data from 5 time points was used, yielding 444 data points. Participants screened positive for PTSD at 20% of visits, and depression at 22% of visits. At visits when participants screened positive for both depression and PTSD, 53.6% of the time they were on an antidepressant. Those who screened positive for PTSD were more likely to also screen positive for depression. In multiple regression analyses that included both continuous and dichotomous PTSD and depression and controlled for shared variance due to clustering of multiple observations, only depression contributed significant unique variance, suggesting the primary role of depression and the secondary role of PTSD in poor adherence in individuals with HIV.
在艾滋病毒/艾滋病患者中，抑郁症状或创伤后应激症状可能会干扰重要的自我护理行为，比如坚持医疗治疗方案的能力。然而，在艾滋病毒护理环境中，这些问题可能常常未被发现。本研究在艾滋病毒/艾滋病护理环境中使用了抑郁和创伤后应激障碍（PTSD）的简短自我报告筛查量表，以检验：（1）这些诊断呈阳性筛查结果的频率；（2）筛查呈阳性者接受抗抑郁治疗的程度；（3）通过药物事件监测系统评估的持续性PTSD和抑郁症状评分之间的关联，以及PTSD和抑郁筛查状态的分类（筛查阳性或阴性）之间的关联，以及它们与抗逆转录病毒治疗依从性之间的关联，无论是否接受抗抑郁治疗。参与者为164名感染艾滋病毒的个体，他们参与了马萨诸塞州艾滋病毒治疗环境中的一项多地点依从性干预研究。使用了来自5个时间点的可用数据，产生了444个数据点。参与者在20%的访视中PTSD筛查呈阳性，在22%的访视中抑郁筛查呈阳性。在参与者抑郁和PTSD筛查均呈阳性的访视中，他们有53.6%的时间在服用抗抑郁药。PTSD筛查呈阳性的人也更有可能抑郁筛查呈阳性。在包含连续性和二分法PTSD及抑郁且控制了由于多次观察聚类导致的共同方差的多元回归分析中，只有抑郁贡献了显著的独特方差，这表明抑郁在艾滋病毒感染者依从性差中起主要作用，而PTSD起次要作用。
