Wagner Glenn J, Ghosh-Dastidar Bonnie, Robinson Eric, Ngo Victoria K, Glick Peter, Musisi Seggane, Akena Dickens
RAND Corporation, 1776 Main St., Santa Monica, CA, 90407, USA.
Department of Psychiatry, Makerere University, College of Health Sciences, P.O. Box 7072, Mulago Hill, Kampala, Uganda.
Int J Behav Med. 2017 Aug;24(4):628-633. doi: 10.1007/s12529-017-9642-7.
Depression is common among people living with HIV, and it is associated with impaired work functioning. However, little research has examined whether depression alleviation improves work-related outcomes in this population, which is the focus of this analysis.
A sample of 1028 depressed HIV clients in Uganda enrolled in a comparative trial of depression care models and were surveyed over 12 months. Serial regression analyses examined whether depression alleviation (measured by the nine-item Patient Health Questionnaire) was associated with change in self-reported weekly amount of hours worked and income earned, and whether these relationships were mediated by change in work-related self-efficacy.
Among those with major depression, depression alleviation was associated with nearly a doubling of weekly hours worked in bivariate analysis. The relationship between depression alleviation and hours worked was partially mediated by change in work self-efficacy among those with major depression, as well as those with minor depression, in multivariate regression analysis that controlled for demographic and health covariates. Depression alleviation was not significantly associated with change in weekly income.
These findings suggest that depression alleviation benefits work functioning at least in part through improved confidence to engage in work-related activities. Integration of depression care services into HIV care may be important for improving the economic well-being of people living with HIV.
抑郁症在艾滋病毒感染者中很常见，且与工作功能受损有关。然而，很少有研究探讨抑郁症缓解是否能改善该人群与工作相关的结果，这正是本分析的重点。
乌干达1028名抑郁的艾滋病毒感染者样本参加了抑郁症护理模式的对比试验，并在12个月内接受了调查。系列回归分析检验了抑郁症缓解（通过九项患者健康问卷测量）是否与自我报告的每周工作小时数和收入变化相关，以及这些关系是否由与工作相关的自我效能感变化介导。
在患有重度抑郁症的患者中，在双变量分析中，抑郁症缓解与每周工作小时数几乎翻倍有关。在控制了人口统计学和健康协变量的多变量回归分析中，抑郁症缓解与工作小时数之间的关系部分由重度抑郁症患者以及轻度抑郁症患者的工作自我效能感变化介导。抑郁症缓解与每周收入变化无显著关联。
这些发现表明，抑郁症缓解至少部分通过提高参与与工作相关活动的信心而有益于工作功能。将抑郁症护理服务纳入艾滋病毒护理可能对改善艾滋病毒感染者的经济状况很重要。
