埃塞俄比亚亚的斯亚贝巴阿莱尔特医院接受随访的艾滋病毒患者中抑郁症和焦虑症的患病率及其相关因素
Prevalence and correlates of depression and anxiety among patients with HIV on-follow up at Alert Hospital, Addis Ababa, Ethiopia.
作者信息
Tesfaw Getachew, Ayano Getinet, Awoke Tadesse, Assefa Dawit, Birhanu Zelalem, Miheretie Getenet, Abebe Genet
机构信息
Department of psychiatry, Felege Hiwot Referral hospital, Bahirdar University, Bahirdar, Ethiopia.
Research and training department, Amanuel mental specialized hospital, Addis Ababa, Ethiopia.
出版信息
BMC Psychiatry. 2016 Nov 2;16(1):368. doi: 10.1186/s12888-016-1037-9.
BACKGROUND
Depression and anxiety disorders are common among people living with Human Immunodeficiency Virus than the non-infected individuals. The co-existence of these disorders are associated with barriers to treatment and worsening medical outcomes, including treatment resistance, increased risk for suicide, greater chance for recurrence and utilization of medical resources and/or increase morbidity and mortality. Therefore, assessing depression and anxiety among HIV patients has a pivotal role for further interventions.
METHODS
Institution based cross-sectional study was conducted at ALERT hospital May, 2015. Data were collected using a pretested, structured and standardized questionnaire. Systematic sampling technique was used to select the study participants. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95 % CI was computed to assess the strength of associations.
RESULTS
The prevalence of co-morbid depression and anxiety among HIV patients was 24.5 % and prevalence of depression and anxiety among HIV patients was 41.2 % (172) and 32.4 % (135) respectively. Multivariate analysis showed that individual who had perceived HIV stigma (AOR = 3.60, 95 % CI (2.23, 5.80), poor social support (AOR = 2.02, 95 % CI (1.25, 3.27), HIV stage III (AOR = 2.80, 95 % CI (1.50, 5.21) and poor medication adherence (AOR = 1.61, 95 % CI (1.02, 2.55) were significantly associated with depression. Being female (AOR = 3.13, 95 % CI (1.80, 5.44), being divorced (AOR = 2.51, 95 % CI (1.26, 5.00), having co morbid TB (AOR = 2.74, 95 % CI (1.37, 5.47) and perceived HIV stigma (AOR = 4.00, 95 % CI (2.40, 6.69) were also significantly associated with anxiety.
CONCLUSION
Prevalence of depression and anxiety was high. Having perceived HIV stigma, HIV Stage III, poor social support and poor medication adherence were associated with depression. Whereas being female, being divorced and having co morbid TB and perceived HIV stigma were associated with anxiety. Ministry of health should give training on how to screen anxiety and depression among HIV patients and should develop guidelines to screen and treat depression and anxiety among HIV patients.
背景
与未感染人类免疫缺陷病毒（HIV）的个体相比，抑郁症和焦虑症在HIV感染者中更为常见。这些疾病的共存与治疗障碍及医疗结局恶化相关，包括治疗抵抗、自杀风险增加、复发几率更高、医疗资源利用增加和/或发病率及死亡率上升。因此，评估HIV患者的抑郁和焦虑状况对进一步干预具有关键作用。
方法
2015年5月在ALERT医院开展了一项基于机构的横断面研究。使用经过预测试、结构化且标准化的问卷收集数据。采用系统抽样技术选取研究参与者。使用二元逻辑回归分析来确定相关因素。计算95%置信区间的比值比以评估关联强度。
结果
HIV患者中抑郁和焦虑共病的患病率为24.5%，HIV患者中抑郁症患病率为41.2%（172例），焦虑症患病率为32.4%（135例）。多变量分析显示，感知到HIV污名的个体（调整后比值比[AOR]=3.60，95%置信区间[CI]为[2.23, 5.80]）、社会支持差（AOR=2.02，95%CI为[1.25, 3.27]）、HIV三期（AOR=2.80，95%CI为[1.50, 5.21]）以及药物依从性差（AOR=1.61，95%CI为[1.02, 2.55]）与抑郁症显著相关。女性（AOR=3.13，95%CI为[1.80, 5.44]）、离异（AOR=2.51，95%CI为[1.26, 5.00]）、合并肺结核（AOR=2.74，95%CI为[1.37, 5.47]）以及感知到HIV污名（AOR=4.00，95%CI为[2.40, 6.69]）也与焦虑症显著相关。
结论
抑郁和焦虑的患病率较高。感知到HIV污名、HIV三期、社会支持差和药物依从性差与抑郁症相关。而女性、离异、合并肺结核以及感知到HIV污名与焦虑症相关。卫生部应开展关于如何筛查HIV患者焦虑和抑郁的培训，并应制定筛查和治疗HIV患者抑郁和焦虑的指南。
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