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乌克兰结核病患者及结核病/艾滋病病毒合并感染者中的抑郁症:一项横断面研究。

Depression among people living with tuberculosis and tuberculosis/HIV coinfection in Ukraine: a cross-sectional study.

作者信息

Salnikova Anna, Makarenko Olena, Sereda Yuliia, Kiriazova Tetiana, Lunze Karsten, DeHovitz Jack, Ompad Danielle C

机构信息

Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.

Department of Medicine, Boston Medical Center, Boston, MA, USA.

出版信息

Glob Health Action. 2025 Dec;18(1):2448894. doi: 10.1080/16549716.2024.2448894. Epub 2025 Feb 13.

Abstract

BACKGROUND

Depressive disorders are associated with poor treatment outcomes, physical health, and quality of life among people living with TB (PLWTB) and TB/HIV (PLWTBHIV). Data on depression among PLWTB/HIV are limited in Ukraine.

OBJECTIVES

This cross-sectional study aimed to examine depression risk and its correlates and describe the willingness to seek depression treatment among PLWTB/HIV in Ukraine.

METHODS

This secondary analysis included patients with and without HIV who initiated TB treatment within 30 days in two tertiary hospitals in Kyiv and Odesa. A survey was conducted from February 2021 to October 2022 and reviewed patients' health records. We used the Center for Epidemiological Studies-Depression Scale (CES-D) to indicate risk for clinical depression. Factors associated with depressive symptoms were identified using logistic regression.

RESULTS

The sample included 209 participants ( = 100 with TB;  = 109 with TB/HIV). The mean age of participants was 43 (SD = 11) years; 66% of sample identified as male. Approximately 28% of participants were at risk for clinical depression; of whom 66% were willing to seek therapeutic or medical help. HIV coinfection (adjusted odds ratio [aOR] = 2.95, 95% confidence interval [CI]: 1.46,6.20), past 30 days illicit drug use (aOR = 3.57, 95% CI = 1.18,11.60), TB stigma (moderate stigma aOR = 7.40, 95% CI = 2.22,34.1; high stigma aOR = 15.50, 95% CI = 4.52,73.20), and unemployment status (aOR = 2.25, 95% CI = 1.12,4.60) were significantly associated with the odds of depressive symptoms among PLWTB.

CONCLUSION

Findings support integration of a brief depression screening tool into routine clinical care of PLWTB/HIV and highlight the importance of linking TB/HIV care with mental health services.

摘要

背景

抑郁症与结核病患者(PLWTB)和结核病/艾滋病患者(PLWTBHIV)的治疗效果不佳、身体健康状况及生活质量相关。乌克兰关于PLWTB/HIV患者抑郁症的数据有限。

目的

这项横断面研究旨在调查乌克兰PLWTB/HIV患者的抑郁风险及其相关因素,并描述他们寻求抑郁症治疗的意愿。

方法

这项二次分析纳入了在基辅和敖德萨的两家三级医院中,在30天内开始接受结核病治疗的有或无艾滋病毒感染的患者。于2021年2月至2022年10月进行了一项调查,并查阅了患者的健康记录。我们使用流行病学研究中心抑郁量表(CES-D)来表明临床抑郁症风险。使用逻辑回归确定与抑郁症状相关的因素。

结果

样本包括209名参与者(=100名结核病患者;=109名结核病/艾滋病患者)。参与者的平均年龄为43岁(标准差=11);66%的样本为男性。约28%的参与者有临床抑郁症风险;其中66%愿意寻求治疗或医疗帮助。合并感染艾滋病毒(调整后的优势比[aOR]=2.95,95%置信区间[CI]:1.46,6.20)、过去30天内使用非法药物(aOR=3.57,95%CI=1.18,11.60)、结核病污名(中度污名aOR=7.40,95%CI=2.22,34.1;高度污名aOR=15.50,95%CI=4.52,73.20)以及失业状况(aOR=2.25,95%CI=1.12,4.60)与PLWTB患者出现抑郁症状的几率显著相关。

结论

研究结果支持将简短的抑郁症筛查工具纳入PLWTB/HIV的常规临床护理中,并强调了将结核病/艾滋病护理与心理健康服务相联系的重要性。

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Risk Factors for Depression in Tuberculosis Patients: A Meta-Analysis.肺结核患者抑郁症的危险因素:一项荟萃分析。
Neuropsychiatr Dis Treat. 2022 Apr 11;18:847-866. doi: 10.2147/NDT.S347579. eCollection 2022.

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