Selvaraj Vijairam, Ross Michael W, Unnikrishnan Bhaskaran, Hegde Supriya
Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas, Houston, USA.
AIDS Care. 2013;25(2):169-72. doi: 10.1080/09540121.2012.689809. Epub 2012 May 29.
Depression in people with HIV has wide-spread implications related to faster progression to AIDS, poor drug compliance, and lower quality of life (QOL). Although there have been studies that have examined the role of sociodemographic variables in people with HIV, there have only been a few on the assessment of QOL and its association with depression among people with HIV in South India. The objectives of this study were to diagnose major depressive disorder (MDD) and examine the association of depression with health-related quality of life (HRQOL) among people with HIV in coastal South India. Structured questionnaires detailing sociodemographic and HIV related variables were filled out by 103 patients with HIV attending a tertiary care center. Interviews were carried out by a psychiatrist to diagnose ICD-10 MDD and a clinical psychologist to rate the severity of depression using the Hamilton Depression Scale (HAMD). Subjective HRQOL was assessed using HIV/AIDS targeted quality of life questionnaire in these patients. Fifty patients were diagnosed with MDD. Among them, 23 (46%) were mildly depressed, 19 (38%) were moderately depressed, 7 (14%) were severely depressed, and 1 (2%) was very severely depressed. Mean QOL scores for all dimensions except sexual function were significantly and inversely correlated (p<0.05) with HAMD implying that patients with greater severity of depressive symptoms had poorer HRQOL. Individuals with ICD-10 diagnosis of MDD presented significantly lower scores of QOL compared to individuals without MDD. The implication is that early diagnosis and referral of depressed patients needs to be incorporated into intervention programs to improve patient outcomes and QOL. More research is needed to investigate the impact of antidepressant therapy on QOL using this study as a comparison group in a similar population.
感染艾滋病毒的人群中存在的抑郁具有广泛影响，涉及到更快发展为艾滋病、较差的药物依从性以及较低的生活质量（QOL）。尽管已有研究探讨了社会人口统计学变量在感染艾滋病毒人群中的作用，但在印度南部，关于生活质量评估及其与感染艾滋病毒人群中抑郁的关联的研究却很少。本研究的目的是诊断重度抑郁症（MDD），并检验印度南部沿海地区感染艾滋病毒人群中抑郁与健康相关生活质量（HRQOL）之间的关联。103名在三级护理中心就诊的艾滋病毒患者填写了详细的社会人口统计学和艾滋病毒相关变量的结构化问卷。由一名精神科医生进行访谈以诊断ICD - 10 MDD，一名临床心理学家使用汉密尔顿抑郁量表（HAMD）对抑郁严重程度进行评分。使用针对艾滋病毒/艾滋病的生活质量问卷对这些患者的主观HRQOL进行评估。50名患者被诊断为MDD。其中，23名（46%）为轻度抑郁，19名（38%）为中度抑郁，7名（14%）为重度抑郁，1名（2%）为极重度抑郁。除性功能外，所有维度的平均生活质量得分与HAMD呈显著负相关（p<0.05），这意味着抑郁症状越严重的患者，其HRQOL越差。与未患MDD的个体相比，被ICD - 10诊断为MDD的个体的生活质量得分显著更低。这意味着需要将抑郁症患者的早期诊断和转诊纳入干预项目，以改善患者的治疗效果和生活质量。需要开展更多研究，以本研究作为类似人群的对照组，调查抗抑郁治疗对生活质量的影响。
