Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa.
J Affect Disord. 2013 Oct;151(1):31-8. doi: 10.1016/j.jad.2013.05.005. Epub 2013 May 31.
Little is known about depression in older people in sub-Saharan Africa, the associated impact of HIV, and the influence on health perceptions.
Examine the prevalence and correlates of depression; explore the relationship between depression and health perceptions in HIV-infected and -affected older people.
In 2010, 422 HIV-infected and -affected participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed participants and a diagnosis of depressive episode was derived from the Composite International Diagnostic Interview (Depression module) using the International Classification of Diseases diagnostic criteria and categorised as major (MDE) or brief (BDE).
Overall, 42.4% (n=179) had a depressive episode (MDE: 22.7%, n=96; BDE: 19.7%, n=83). Prevalence of MDE was significantly higher in HIV-affected (30.1%, 95% CI 24.0-36.2%) than HIV-infected (14.8%, 95% CI 9.9-19.7%) participants; BDE was higher in HIV-infected (24.6%, 95% CI 18.7-30.6%) than in HIV-affected (15.1%, 95% CI 10.3-19.8%) participants. Being female (aOR 3.04, 95% CI 1.73-5.36), receiving a government grant (aOR 0.34, 95% CI 0.15-0.75), urban residency (aOR 1.86, 95% CI 1.16-2.96) and adult care-giving (aOR 2.37, 95% CI 1.37-4.12) were significantly associated with any depressive episode. Participants with a depressive episode were 2-3 times more likely to report poor health perceptions.
Study limitations include the cross-sectional design, limited sample size and possible selection biases.
Prevalence of depressive episodes was high. Major depressive episodes were higher in HIV-affected than HIV-infected participants. Psycho-social support similar to that of HIV treatment programmes around HIV-affected older people may be useful in reducing their vulnerability to depression.
在撒哈拉以南非洲地区，人们对老年人的抑郁情况、艾滋病毒的相关影响以及对健康认知的影响知之甚少。
调查抑郁的流行率和相关因素；探讨艾滋病毒感染和受影响的老年人中抑郁与健康认知之间的关系。
2010 年，招募了 422 名年龄在 50 岁及以上的艾滋病毒感染者和受影响者参与一项横断面研究。护士专业人员对参与者进行了访谈，根据国际疾病分类诊断标准，使用复合国际诊断访谈（抑郁模块）诊断出抑郁发作，并分为重度抑郁发作（MDE）或轻度抑郁发作（BDE）。
总体而言，42.4%（n=179）有抑郁发作（MDE：22.7%，n=96；BDE：19.7%，n=83）。与艾滋病毒感染者（14.8%，95%CI 9.9-19.7%）相比，艾滋病毒受影响者（30.1%，95%CI 24.0-36.2%）中 MDE 的患病率明显更高；与艾滋病毒感染者（24.6%，95%CI 18.7-30.6%）相比，艾滋病毒受影响者（15.1%，95%CI 10.3-19.8%）中 BDE 更高。女性（优势比 3.04，95%CI 1.73-5.36）、获得政府补助（优势比 0.34，95%CI 0.15-0.75）、城市居住（优势比 1.86，95%CI 1.16-2.96）和成年护理（优势比 2.37，95%CI 1.37-4.12）与任何抑郁发作显著相关。有抑郁发作的参与者报告健康认知较差的可能性是没有抑郁发作的参与者的 2-3 倍。
研究的局限性包括横断面设计、样本量有限以及可能存在选择偏倚。
抑郁发作的患病率很高。与艾滋病毒感染者相比，艾滋病毒受影响者的重度抑郁发作更为常见。针对艾滋病毒受影响老年人的艾滋病毒治疗方案类似的心理社会支持可能有助于降低他们患抑郁症的脆弱性。
