Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
J Affect Disord. 2013 Jul;149(1-3):108-15. doi: 10.1016/j.jad.2013.01.011. Epub 2013 Feb 27.
Depression has significant effects on morbidity and mortality in people living with HIV (PLWH). Current study estimated the rate of depressive disorder and identified the correlates of depressive disorder among PLWH in China.
258 PLWH in China were recruited and interviewed with a structured questionnaire including measurements testing perceived stress, social support, perceived discrimination, and depression. Mediating effect of perceived stress between perceived discrimination and depression and moderating effect of social support on effect of perceived discrimination and perceived stress to depression were tested. Multivariate regression was used to examine the determinants of depression.
The prevalence of mild to severe depression is 71.9%. The relationship between the perceived discrimination and depression is fully mediated by perceived stress (perceived discrimination that was statistically significant (β=0.153) to depression became non-significant after adding perceived stress in the regression model). Interaction term between social support and perceived stress has negative effects (β=-0.117) and explained a significant amount of variance (R(2)=0.018) in depression. Lower income, and higher perceived stress predicted more depressive symptoms.
Cross-sectional study and self-report bias are major limitations of this study.
Depression among PLWH is a severe problem in China. Primary health care workers need to be trained in recognition and treatment in depression. Stress management skills and social support for PLWH are warranted.
抑郁对艾滋病毒感染者(PLWH)的发病率和死亡率有重大影响。本研究估计了中国 PLWH 中抑郁障碍的发生率,并确定了抑郁障碍的相关因素。
在中国招募了 258 名 PLWH,并通过结构化问卷对其进行了访谈,该问卷包括测试感知压力、社会支持、感知歧视和抑郁的测量。测试了感知歧视和抑郁之间的感知压力的中介作用,以及社会支持对感知歧视和感知压力对抑郁影响的调节作用。多元回归用于检查抑郁的决定因素。
轻度至重度抑郁的患病率为 71.9%。感知歧视与抑郁之间的关系完全由感知压力介导(感知歧视对抑郁的影响具有统计学意义(β=0.153),但在回归模型中加入感知压力后变得不显著)。社会支持与感知压力之间的交互项具有负效应(β=-0.117),并解释了抑郁的显著方差(R(2)=0.018)。较低的收入和较高的感知压力预示着更多的抑郁症状。
本研究存在横断面研究和自我报告偏倚的局限性。
中国 PLWH 中的抑郁是一个严重的问题。初级卫生保健工作者需要接受识别和治疗抑郁的培训。需要为 PLWH 提供压力管理技能和社会支持。