Brody Lilla A, Kamalyan Lily, Karcher Kayle, Guarena Lesley A, Bender Alexis A, McKenna Benjamin S, Umlauf Anya, Franklin Donald, Marquine Maria J, Heaton Robert K
Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, USA.
Department of Psychiatry, HIV Neurobehavioral Research Program, San Diego, CA, USA.
Patient Relat Outcome Meas. 2023 Feb 15;14:15-30. doi: 10.2147/PROM.S391113. eCollection 2023.
Depression and other aspects of emotional health in people with HIV (PWH) can affect functional independence, disease progression, and overall life quality. This study used the NIH Toolbox Emotion Battery (NIHTB-EB), which assesses many features of emotional health, to more comprehensively investigate differences among adults living with and without HIV, and to identify factors associated with emotional health for PWH.
Participants (n=1451; age: M=50.19, SD=16.84; 47.90% women) included 433 PWH living in southern California seen from 2003 to 2021 (64.72% AIDS, 92.25% on antiretroviral therapy) and 1018 healthy participants from NIHTB-EB national normative cohort. Participants completed the NIHTB-EB and PWH underwent comprehensive HIV disease and psychiatric evaluations. We investigated differences in emotional health by HIV status via independent samples -tests (continuous scores) and Chi tests ("problematic" emotional health scores). Multivariable linear regression models examined correlates of emotional health among PWH.
PWH had significantly worse emotional health than people without HIV across Social Satisfaction (Cohen's d=0.71, <0.001), Psychological Well-Being (Cohen's d=0.49, <0.001) and Negative Affect (Cohen's d=0.19, <0.01) summary T-scores, and most component scales. PWH also had higher rates of "problematic" emotional health, particularly in Social Satisfaction (45% vs 17%, <0.0001). Poor emotional health among PWH was associated with lifetime Major Depressive and Substance Use Disorders, relationship status (lost relationship versus in relationship), unemployment, and cognitive difficulties and loss of functional independence.
The NIHTB-EB identified that difficulties with multiple aspects of emotional health are common among PWH, and appear to be relatively independent of cognitive impairment as well as HIV disease and treatment history, but are strongly associated with everyday functioning. Given the cross-sectional nature of this study, longitudinal studies should be employed to evaluate causality pertaining to predictors of emotional health in PWH. These findings may inform interventions to promote emotional wellbeing in PWH.
感染艾滋病毒者（PWH）的抑郁及情绪健康的其他方面会影响功能独立性、疾病进展和整体生活质量。本研究使用美国国立卫生研究院工具包情绪量表（NIHTB-EB），该量表评估情绪健康的多个特征，以更全面地调查感染和未感染艾滋病毒的成年人之间的差异，并确定与PWH情绪健康相关的因素。
参与者（n = 1451；年龄：M = 50.19，标准差 = 16.84；47.90%为女性）包括2003年至2021年在南加州就诊的433名PWH（64.72%患有艾滋病，92.25%接受抗逆转录病毒治疗）以及来自NIHTB-EB全国标准队列的1018名健康参与者。参与者完成了NIHTB-EB测试，PWH接受了全面的艾滋病毒疾病和精神科评估。我们通过独立样本t检验（连续评分）和卡方检验（“有问题的”情绪健康评分）调查了不同艾滋病毒感染状况下的情绪健康差异。多变量线性回归模型检验了PWH情绪健康的相关因素。
在社会满意度（科恩d值 = 0.71，P < 0.001）、心理健康（科恩d值 = 0.49，P < 0.001）和消极情绪（科恩d值 = 0.19，P < 0.01）的汇总T分数以及大多数分量表方面，PWH的情绪健康状况明显比未感染艾滋病毒者差。PWH“有问题的”情绪健康发生率也更高，尤其是在社会满意度方面（45%对17%，P < 0.0001）。PWH情绪健康不佳与终生重度抑郁和物质使用障碍、恋爱状况（失恋与恋爱中）、失业以及认知困难和功能独立性丧失有关。
NIHTB-EB表明，情绪健康多个方面的困难在PWH中很常见，似乎相对独立于认知障碍以及艾滋病毒疾病和治疗史，但与日常功能密切相关。鉴于本研究的横断面性质，应采用纵向研究来评估与PWH情绪健康预测因素相关的因果关系。这些发现可能为促进PWH情绪健康的干预措施提供参考。
