越南胡志明市安和诊所HIV阳性患者抑郁症状的变化及其相关因素
Changes in depressive symptoms and correlates in HIV+ people at An Hoa Clinic in Ho Chi Minh City, Vietnam.
作者信息
Huynh Van-Anh N, To Kien G, Do Dung Van, To Quyen G, Nguyen Mai T H
机构信息
Faculty of Public Health, University of Medicine and Pharmacy, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam.
Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road Kelvin Grove, Brisbane, Queensland, 4059, Australia.
出版信息
BMC Psychiatry. 2017 Jan 21;17(1):35. doi: 10.1186/s12888-016-1170-5.
BACKGROUND
Understanding of depression among Vietnamese people living with HIV (PLWH) is limited. This longitudinal study examines changes in depressive symptoms and identifies its correlates among people living with HIV under antiretroviral therapy at An Hoa Clinic.
METHODS
People living with HIV ≥18 years and undergoing antiretroviral therapy for ≥3 months were eligible. Those at final AIDS stage, too ill, or illiterate were excluded due to their inability to complete the self-administered questionnaire. One researcher was present in the clinic for a month inviting PLWH to participate. Data were collected from 242 PLWH at baseline (T1) and 234 after three months (T2). Depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale (CESD). Social relationship was measured using questions created by World Health Organization. Generalized Estimating Equations were used examining changes in depressive symptoms with CESD cut-off <16/≥16 (mild depression) and cut-off <23/≥23 (major depression).
RESULTS
Model 1 (CESD cut-off <16/≥16) showed that participants were not more likely to have depressive symptoms at T2 compared to T1 (OR = 1.15, p > 0.05). Those with a co-morbidity were more likely to have depressive symptoms than those without a co-morbidity (OR = 1.76, p < 0.05). Those with higher social relationship scores were less likely to have depressive symptoms than those with lower scores (OR = 0.76, p < 0.001). Model 2 (CESD cut-off <23/≥23) showed that participants were more likely to have major depressive symptoms at T2 compared to T1 (OR = 1.6, p < 0.01) and those with higher social relationship score were less likely to have major depressive symptoms than those with lower scores (OR = 0.73, p < 0.001).
CONCLUSIONS
People living with HIV were not more likely to have depressive symptoms (<16/≥16) but were more likely to have major depressive symptoms (<23/≥23) at T2 vs. T1. Social relationship was found to be strongly associated with depressive symptoms. Associations between age, individual income status, and co-morbidity with depressive symptoms were not decisive. Gender, ethnicity, education, religion, marriage, household economy, and adherence were not correlates.
背景
越南艾滋病毒感染者（PLWH）对抑郁症的了解有限。这项纵向研究调查了接受抗逆转录病毒治疗的艾滋病毒感染者的抑郁症状变化，并确定了其相关因素。
方法
年龄≥18岁且接受抗逆转录病毒治疗≥3个月的艾滋病毒感染者符合条件。处于艾滋病终末期、病情过重或文盲者因无法完成自填问卷而被排除。一名研究人员在诊所驻点一个月，邀请艾滋病毒感染者参与。在基线期（T1）收集了242名艾滋病毒感染者的数据，三个月后（T2）收集了234名感染者的数据。抑郁症状通过流行病学研究中心抑郁量表（CESD）进行测量。社会关系使用世界卫生组织编制的问题进行测量。使用广义估计方程来研究CESD临界值<16/≥16（轻度抑郁）和临界值<23/≥23（重度抑郁）时抑郁症状的变化。
结果
模型1（CESD临界值<16/≥16）显示，与T1相比，参与者在T2时出现抑郁症状的可能性并未增加（OR = 1.15，p>0.05）。患有合并症的参与者比未患有合并症的参与者更易出现抑郁症状（OR = 1.76，p<0.05）。社会关系得分较高的参与者比得分较低的参与者出现抑郁症状的可能性更小（OR = 0.76，p<0.001）。模型2（CESD临界值<23/≥23）显示，与T1相比，参与者在T2时出现重度抑郁症状的可能性更大（OR = 1.6，p<0.01），且社会关系得分较高的参与者比得分较低的参与者出现重度抑郁症状的可能性更小（OR = 0.73，p<0.001）。
结论
与T1相比，艾滋病毒感染者在T2时出现抑郁症状（<16/≥16）的可能性并未增加，但出现重度抑郁症状（<23/≥23）的可能性更大。研究发现社会关系与抑郁症状密切相关。年龄、个人收入状况以及合并症与抑郁症状之间的关联并不明确。性别、种族、教育程度、宗教信仰、婚姻状况、家庭经济状况和依从性与抑郁症状无关。
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