瑞士HIV队列研究（SHCS）参与者中抑郁症的发生率及风险因素

Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS).

作者信息

Anagnostopoulos Alexia, Ledergerber Bruno, Jaccard René, Shaw Susy Ann, Stoeckle Marcel, Bernasconi Enos, Barth Jürgen, Calmy Alexandra, Berney Alexandre, Jenewein Josef, Weber Rainer

机构信息

Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.

Independent Researcher, HIV Practitioner, Zurich, Switzerland.

出版信息

PLoS One. 2015 Oct 22;10(10):e0140943. doi: 10.1371/journal.pone.0140943. eCollection 2015.

DOI:10.1371/journal.pone.0140943

PMID:26492488

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4619594/

Abstract

OBJECTIVES

We studied the incidence and prevalence of, and co-factors for depression in the Swiss HIV Cohort Study.

METHODS

Depression-specific items were introduced in 2010 and prospectively collected at semiannual cohort visits. Clinical, laboratory and behavioral co-factors of incident depression among participants free of depression at the first two visits in 2010 or thereafter were analyzed with Poisson regression. Cumulative prevalence of depression at the last visit was analyzed with logistic regression.

RESULTS

Among 4,422 participants without a history of psychiatric disorders or depression at baseline, 360 developed depression during 9,348 person-years (PY) of follow-up, resulting in an incidence rate of 3.9 per 100 PY (95% confidence interval (CI) 3.5-4.3). Cumulative prevalence of depression during follow-up was recorded for 1,937/6,756 (28.7%) participants. Incidence and cumulative prevalence were higher in injection drug users (IDU) and women. Older age, preserved work ability and higher physical activity were associated with less depression episodes. Mortality (0.96 per 100 PY, 95% CI 0.83-1.11) based upon 193 deaths over 20,102 PY was higher among male IDU (2.34, 1.78-3.09), female IDU (2.33, 1.59-3.39) and white heterosexual men (1.32, 0.94-1.84) compared to white heterosexual women and homosexual men (0.53, 0.29-0.95; and 0.71, 0.55-0.92). Compared to participants free of depression, mortality was slightly elevated among participants with a history of depression (1.17, 0.94-1.45 vs. 0.86, 0.71-1.03, P = 0.033). Suicides (n = 18) did not differ between HIV transmission groups (P = 0.50), but were more frequent among participants with a prior diagnosis of depression (0.18 per 100 PY, 95%CI 0.10-0.31; vs. 0.04, 0.02-0.10; P = 0.003).

CONCLUSIONS

Depression is a frequent co-morbidity among HIV-infected persons, and thus an important focus of care.

摘要

目的

在瑞士HIV队列研究中，我们研究了抑郁症的发病率、患病率及其相关因素。

方法

2010年引入了特定于抑郁症的项目，并在每半年一次的队列随访中进行前瞻性收集。对2010年或之后前两次随访时无抑郁症的参与者中，新发抑郁症的临床、实验室和行为相关因素进行泊松回归分析。对最后一次随访时抑郁症的累积患病率进行逻辑回归分析。

结果

在基线时无精神疾病或抑郁症病史的4422名参与者中，360人在9348人年的随访期间患上抑郁症，发病率为每100人年3.9例（95%置信区间（CI）3.5 - 4.3）。随访期间1937/6756（28.7%）的参与者记录了抑郁症的累积患病率。注射吸毒者（IDU）和女性的发病率和累积患病率更高。年龄较大、工作能力保留和身体活动水平较高与抑郁症发作次数较少相关。基于20102人年中的193例死亡，男性IDU（2.34，1.78 - 3.09）、女性IDU（2.33，1.59 - 3.39）和白人异性恋男性（1.32，0.94 - 1.84）的死亡率（每100人年0.96例，95%CI 0.83 - 1.11）高于白人异性恋女性和男同性恋者（0.53，0.29 - 0.95；以及0.71，0.55 - 0.92）。与无抑郁症的参与者相比，有抑郁症病史的参与者死亡率略有升高（1.17，0.94 - 1.45对0.86，0.71 - 1.03，P = 0.033）。自杀（n = 18）在HIV传播组之间无差异（P = 0.50），但在先前诊断为抑郁症的参与者中更常见（每100人年0.18例，95%CI 0.10 - 0.31；对0.04，0.02 - 0.10；P = 0.003）。