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在马来亚大学医学中心,感染人类免疫缺陷病毒的成年人中抑郁、焦虑的流行率及其相关因素。

The prevalence of depression, anxiety and associated factors among adults with living human immunodeficiency virus in University Malaya Medical Centre.

机构信息

Faculty of Medicine, Department of Psychological Medicine, University Malaya Centre for Addiction Sciences, 37447University of Malaya, Kuala Lumpur, Malaysia.

Department of Social and Preventive Medicine, Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Int J STD AIDS. 2022 Sep;33(10):880-889. doi: 10.1177/09564624221106528. Epub 2022 Jul 8.

Abstract

BACKGROUND

This study estimates prevalence of depression and anxiety among adults living with Human Immunodeficiency Virus (HIV) in University Malaya Medical Centre (UMMC) and determines its associated factors.

METHODS

This cross-sectional study was conducted between August 2020 and January 2021, in the Infectious Disease clinic and ward. One hundred ninety-one patients were recruited via convenience sampling. Patients' sociodemographic were obtained, followed by Depression, Anxiety, Stress Scale -21 (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and M.I.N.I. international neuropsychiatric interview (M.I.N.I.) The cut off DASS-21 point for depression is ≥5, for anxiety, ≥ 4. Mann-Whitney U and Chi square test were used to analyse the association between variables, and logistic regression to find predictability.

RESULTS

Of the 191 participants, 89.5% outpatient, mean age 40 years (SD 0.742), 91.1% male, 65.4% single, 71.2% working, 46.1% Malaysian Chinese, 59.8% non- heterosexual, mean 6 years of being HIV positive; mean CD4 count 449/μL; mean viral load 116,690 (median = 20). 85.9% were taking antiretroviral therapy. The prevalence of depression was 35.1% ( = 67); anxiety was 42.9% ( = 82). Regression analysis revealed anxiety and stress increased odds of depression by 3.8 times ( = .001) and 12 times ( < .001) respectively. Those 40 years old and younger had 2.3 times odds of anxiety ( = .048). Increased social support from friends increased odds of anxiety by 1.7 times ( = .018). Depression and stress increased odds of anxiety by 4.4 times ( = .001) and 3.7 times ( = .008) respectively.

CONCLUSIONS

Depression and anxiety among people with HIV is often under-recognised. Early identification and treatment of the mental illness is warranted. Screening with DASS-21 is useful to detect depression in patients with HIV.

摘要

背景

本研究估计了在马来亚大学医学中心(UMMC)感染人类免疫缺陷病毒(HIV)的成年人中抑郁和焦虑的患病率,并确定了其相关因素。

方法

本横断面研究于 2020 年 8 月至 2021 年 1 月在传染病门诊和病房进行。通过方便抽样招募了 191 名患者。获得了患者的社会人口统计学资料,随后进行了抑郁、焦虑和压力量表 21 项(DASS-21)、多维感知社会支持量表(MSPSS)和国际神经精神病学访谈的 MINI 版(MINI)。DASS-21 用于评估抑郁的截断点为≥5,用于评估焦虑的截断点为≥4。采用曼-惠特尼 U 检验和卡方检验分析变量之间的关系,采用逻辑回归分析寻找预测因素。

结果

191 名参与者中,89.5%为门诊患者,平均年龄 40 岁(标准差 0.742),91.1%为男性,65.4%为单身,71.2%为在职人员,46.1%为马来西亚华人,59.8%为非异性恋,平均 HIV 阳性时间为 6 年;平均 CD4 计数为 449/μL;平均病毒载量为 116690(中位数=20)。85.9%的患者正在接受抗逆转录病毒治疗。抑郁的患病率为 35.1%(=67),焦虑的患病率为 42.9%(=82)。回归分析显示,焦虑和压力分别使抑郁的患病风险增加 3.8 倍(=0.001)和 12 倍(<0.001)。40 岁及以下的患者焦虑的患病风险增加 2.3 倍(=0.048)。来自朋友的社会支持增加,焦虑的患病风险增加 1.7 倍(=0.018)。抑郁和压力分别使焦虑的患病风险增加 4.4 倍(=0.001)和 3.7 倍(=0.008)。

结论

HIV 感染者的抑郁和焦虑常常未被识别。有必要对精神疾病进行早期识别和治疗。使用 DASS-21 进行筛查可有助于发现 HIV 患者的抑郁。

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