Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Mental Health and Behaviour Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
AIDS Res Ther. 2024 Jun 7;21(1):38. doi: 10.1186/s12981-024-00628-1.
People with HIV/AIDS (PWHA) have 7-36 times greater risk for completed suicide associated with depression symptoms compared to general population. However, no study has sufficiently analyzed the mediating or moderating variables of the relationship between depression and suicidal ideation in Rwanda.
This study aimed to examine how complicated grief mediates and substance abuse moderates the effects of depression symptoms on suicidal ideation.
Data were collected from a convenient sample of 140 participants (M-age = 38.79 years, SD = 10.218) receiving antiretroviral therapy (ART) at Remera Health Center in a cross-sectional study. Multiple linear regression and Sobel test were used to examine the relationships between depression symptoms, complicated grief, suicidal ideation, and substance abuse.
The results indicated that 29% of the sample had clinically significant symptoms of depression and 18% had suicidal ideation. The interaction between substance abuse and depression symptoms (β = .468, t = 8.02, p = 0.000) was a significant predictor, explaining the 55.7% of variance in suicidal ideation. Furthermore, the Sobel test demonstrated that complicated grief mediated the effects of depression symptoms (t = 4.67, SE = 0.0101, p ≤ 0.001) on suicidal ideation.
The results suggest that depression symptoms are associated with an increased risk of suicidal ideation, and this risk significantly amplified in the presence of complicated grief and substance abuse. These findings highlight the importance of integrating mental health services, particularly those addressing depression, complicated grief, and substance abuse, into HIV care programs to mitigate the risk of suicidal ideation among PWHA.
与普通人群相比，HIV/AIDS 患者（PWHA）因抑郁症状而自杀的风险要高 7-36 倍。然而，卢旺达尚未有研究充分分析抑郁与自杀意念之间关系的中介或调节变量。
本研究旨在探讨复杂悲伤如何在抑郁症状对自杀意念的影响中起中介作用，以及物质滥用如何起调节作用。
本横断面研究采用方便抽样法，从雷梅拉健康中心接受抗逆转录病毒治疗（ART）的 140 名参与者（M-年龄=38.79 岁，SD=10.218）中收集数据。采用多元线性回归和 Sobel 检验来检验抑郁症状、复杂悲伤、自杀意念和物质滥用之间的关系。
结果表明，29%的样本有临床显著的抑郁症状，18%有自杀意念。物质滥用和抑郁症状之间的交互作用（β=0.468，t=8.02，p=0.000）是一个显著的预测因子，解释了自杀意念 55.7%的方差。此外，Sobel 检验表明，复杂悲伤介导了抑郁症状（t=4.67，SE=0.0101，p≤0.001）对自杀意念的影响。
结果表明，抑郁症状与自杀意念的风险增加相关，而在存在复杂悲伤和物质滥用的情况下，这种风险显著放大。这些发现强调了将心理健康服务，特别是那些针对抑郁、复杂悲伤和物质滥用的服务，纳入 HIV 护理计划的重要性，以降低 PWHA 自杀意念的风险。
