Beckford Jarrett Sharlene, De La Haye Winston, Miller Zahra, Figueroa J Peter, Duncan Jacqueline, Harvey Kevin
a Global Health Sciences , University of California San Francisco , San Francisco , CA , USA.
b Ministry of Health , Kingston , Jamaica.
AIDS Care. 2018 May;30(5):604-608. doi: 10.1080/09540121.2017.1384786. Epub 2017 Oct 3.
This cross-sectional study explored the range of psychiatric and substance use disorders and unmet need for mental health care among 84 HIV-positive and 44 HIV-negative public clinic attendees in Jamaica. We used a brief interviewer-administered diagnostic tool, the Client Diagnostic Questionnaire. Two-thirds (65.6%) screened positive for at least one psychiatric disorder; 30.5% screened positive for multiple disorders. The most common disorders were post-traumatic stress disorder (PTSD) (41.4%), alcohol abuse (22.7%), and depressive disorders (21.9%). One in fourteen (7.1%) participants with at least one diagnosis received care in the last 6 months. Adjusting for age and sex, PTSD was associated with non-adherence to antiretroviral treatment (AOR = 5.32), anxiety disorders (AOR = 5.82), depression (AOR = 4.29), and suicidal ideation (AOR = 8.17). Psychiatric and substance use disorders, particularly PTSD, were common among STI/HIV clinic attendees in Jamaica. Such clinics may be efficient places to screen, identify, and treat patients with psychiatric disorders in low- and middle- income countries.
这项横断面研究探讨了牙买加84名艾滋病毒呈阳性和44名艾滋病毒呈阴性的公共诊所就诊者中精神疾病和物质使用障碍的范围以及未满足的心理健康护理需求。我们使用了一种由访谈员简短管理的诊断工具——客户诊断问卷。三分之二（65.6%）的人至少筛查出一种精神疾病呈阳性；30.5%的人多种疾病筛查呈阳性。最常见的疾病是创伤后应激障碍（PTSD）（41.4%）、酒精滥用（22.7%）和抑郁症（21.9%）。在至少有一项诊断的参与者中，十四分之一（7.1%）的人在过去6个月接受了治疗。在对年龄和性别进行调整后，创伤后应激障碍与抗逆转录病毒治疗不依从性相关（调整后比值比[AOR]=5.32）、焦虑症（AOR=5.82）、抑郁症（AOR=4.29）和自杀意念（AOR=8.17）。精神疾病和物质使用障碍，尤其是创伤后应激障碍，在牙买加性传播感染/艾滋病毒诊所就诊者中很常见。在低收入和中等收入国家，此类诊所可能是筛查、识别和治疗精神疾病患者的有效场所。
