Wagner Glenn J, Ngo Victoria K, Nakasujja Noeline, Akena Dickens, Aunon Frances, Musisi Seggane
RAND Corporation, Santa Monica, California.
Makerere University, Kampala, Uganda.
Int J Psychiatry Med. 2014;48(3):155-66. doi: 10.2190/PM.48.3.a.
Depression has been found to impede several health outcomes among people living with HIV, but little research has examined whether depression treatment mitigates this influence. We assessed the impact of antidepressant therapy on measures of work, condom use, and psychosocial well-being among depressed HIV clients in Uganda.
Paired t-tests and McNemar tests were used to assess change in survey data collected from participants at initiation of antidepressant therapy (baseline) and 6 months later.
Ninety-five participants completed the 6-month assessment, of whom 82 (86%) responded to treatment (defined as Patient Health Questionnaire-9 score < 5). Among study completers, work functioning improved significantly, as did measures of self-efficacy related to condom use and work (as well as general self-efficacy), and internalized HIV stigma declined; however, actual engagement in work activity and consistent condom use did not show significant change. Similar findings were observed among treatment responders.
Antidepressant treatment benefits functional capacity, psychological well-being, and cognitive intermediary factors that may be essential for behavioral change related to work and condom use, but supplementary therapeutic strategies may be needed to impact more direct behavioral change.
研究发现抑郁症会妨碍艾滋病毒感染者的多种健康状况,但很少有研究探讨抑郁症治疗是否能减轻这种影响。我们评估了抗抑郁治疗对乌干达抑郁艾滋病毒感染者的工作、避孕套使用及心理社会幸福感指标的影响。
采用配对t检验和麦克尼马尔检验来评估从参与者开始抗抑郁治疗时(基线)及6个月后收集的调查数据的变化。
95名参与者完成了6个月的评估,其中82人(86%)对治疗有反应(定义为患者健康问卷-9得分<5)。在完成研究的参与者中,工作功能显著改善,与避孕套使用和工作相关的自我效能感指标(以及一般自我效能感)也有所改善,内化的艾滋病毒耻辱感下降;然而,实际工作活动参与度和持续使用避孕套情况未显示出显著变化。在治疗有反应者中也观察到类似结果。
抗抑郁治疗有益于功能能力、心理健康以及认知中介因素,这些因素可能对与工作和避孕套使用相关的行为改变至关重要,但可能需要补充治疗策略来影响更直接的行为改变。