Okello Elialilia S, Ngo Victoria K, Ryan Gerry, Musisi Seggane, Akena Dickens, Nakasujja Noeline, Wagner Glenn
a Department of Psychiatry , Makerere University, College of Health Sciences , PO Box 7072 , Mulago Hill , Kampala , Uganda.
Afr J AIDS Res. 2012 Mar;11(1):37-44. doi: 10.2989/16085906.2012.671260.
The study set out to explore how HIV-positive individuals conceptualise and describe depression and its manifestation in their lives, and how this may change over time in the context of antiretroviral therapy (ART) and antidepressant treatment. We conducted in-depth interviews using a semi-structured interview guide with 26 adult HIV-positive clients receiving ART in Uganda. We asked the participants to describe their depression and its impact on their general health, physical functioning and psychological wellbeing, as well as the influences of receiving ART or antidepressant treatment. Although depressive experience among the patients was largely described in terms of criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), some of the symptoms used to describe depression, such as 'thinking too much' or worrisome thoughts, did not fit into the DSM-IV criteria. The participants attributed their depression to news of the HIV diagnosis, a fear of dying, the potential socioeconomic consequences of their HIV infection on their family, ART side-effects and continued bad health. Their subjective reports indicated that the treatment of depression with antidepressants had made a positive impact on their general and psychological health. These findings highlight the need for models of HIV care that integrate mental health services and promote the diagnosis and treatment of depression in culturally sensitive ways so as to improve the quality of life and health outcomes for clients. However, keeping the particular study design in mind, these findings should be interpreted as preliminary.
该研究旨在探讨艾滋病毒呈阳性的个体如何理解和描述抑郁症及其在他们生活中的表现，以及在抗逆转录病毒疗法（ART）和抗抑郁治疗的背景下，这可能如何随时间变化。我们使用半结构化访谈指南，对乌干达26名接受抗逆转录病毒治疗的成年艾滋病毒呈阳性患者进行了深入访谈。我们要求参与者描述他们的抑郁症及其对整体健康、身体机能和心理健康的影响，以及接受抗逆转录病毒治疗或抗抑郁治疗的影响。尽管患者的抑郁经历在很大程度上是根据《精神疾病诊断与统计手册》（DSM-IV-TR）中的标准来描述的，但一些用于描述抑郁症的症状，如“想得太多”或令人担忧的想法，并不符合DSM-IV的标准。参与者将他们的抑郁症归因于艾滋病毒诊断的消息、对死亡的恐惧、艾滋病毒感染对其家庭可能产生的社会经济后果、抗逆转录病毒治疗的副作用以及持续的健康不佳。他们的主观报告表明，使用抗抑郁药治疗抑郁症对他们的整体健康和心理健康产生了积极影响。这些发现凸显了建立艾滋病毒护理模式的必要性，该模式应整合心理健康服务，并以文化敏感的方式促进抑郁症的诊断和治疗，从而改善患者的生活质量和健康结果。然而，考虑到特定的研究设计，这些发现应被视为初步结果。
