Depression in HIV-positive patients: the reality of a Portuguese hospital
DOI:
https://doi.org/10.15448/1980-6108.2015.2.20469Keywords:
depression, depressive symptoms, HIV, HIV seropositivity, CD4-positive T-lymphocytes, viral load.Abstract
Aims: Depression is the most common psychiatric disorder among people infected with HIV. This study aims to characterize the Hospital of Joaquim Urbano population of HIV-infected patients’ profile regarding depressive symptoms and whether they correlate with the analytical parameters most frequently evaluated in the context of infection by this virus – HIV viral load, CD4+ count and CD4+ percentage.
Methods: We conducted an observational descriptive and analytical study. The participants’ level of depressive symptoms was assessed with the Beck Depression Inventory. The medical and psychiatric history and the analytical values of viral load, CD4+ count and CD4+ percentage were obtained by consulting the participants’ clinical processes.
Results: A prevalence of 65.5% in HIV-infected patients’ depressive symptoms was found, with a considerable high percentage of subjects presenting with severe symptoms (32.7%). No associations between the depressive symptoms’ levels and CD4+ count, CD4+ percentage or viral load were found. However, depressive symptoms were associated with substance abuse and education level.
Conclusions: The high prevalence of depressive symptoms found in this study reinforces the importance of monitoring this type of symptoms in HIV-infected subjects. The fact that there have been no associations between depressive symptoms and the analytical parameters evaluated is in line with previous studies.
Downloads
References
Organização Mundial de Saúde. Key facts on global HIV epidemic and progress in 2010 [Internet]. 2011 [cited 2011 November 30]. Available from: http://www.who.int/hiv/pub/progress_report2011/global_facts/en/index.html
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas, 2011. HIV Surveillance Report, 2011; vol. 23
Owe-Larsson B, Säll L, Salamon E, Allgulander C. HIV infection and psychiatric illness. Afr J Psychiatry. 2009;12:115-28. http://dx.doi.org/10.4314/ajpsy.v12i2.43729
Hinkin C, Castellon S, Atkinson J, Goodkin K. Neuropsychiatric aspects of HIV infection among older adults. J Clin Epidemiol. 2001;54:S44-S52. http://dx.doi.org/10.1016/S0895-4356(01)00446-2
Dubé B, Benton T, Cruess G, Evans D. Neuropsychiatric manifestations of HIV infection and AIDS. J Psychiatry Neurosci. 2005;30(4):237-46.
Akena D, Musisi S, Kinyanda E. A comparison of the clinical features of depression in HIV-positive and HIV-negative patients in Uganda. Afr J Psychiatry. 2010;13:43-51. http://dx.doi.org/10.4314/ajpsy.v13i1.53429
Vink F, Suliman S, Buck N, Kidd M, Seedat S. Psychopathology, fundamental assumptions and CD-4 T lymphocyte counts in HIV-positive patients. Afr J Psychiatry. 2010;13:267-74. http://dx.doi.org/10.4314/ajpsy.v13i4.61875
Alciati A, Ferri A, Rozzi S, Monforte A, Colmegna F, Valli I, Mellado C. Changes in Lymphocyte Subsets in Depressed HIV-Infected Patients Without Antiretroviral Therapy. Psychosomatics. 2001;42:247-51. http://dx.doi.org/10.1176/appi.psy.42.3.247
Treisman G, Angelino A. Interrelation between Psychiatric Disorders and the Prevention and Treatment of HIV Infection. Clin Infect Dis. 2007;45:S313-S7. http://dx.doi.org/10.1086/522556
Baillargeon J, Ducate S, Pulvino J, Bradshaw P, Murray O, Olvera R. The Association of Psychiatric Disorders and HIV Infection in the Correctional Setting. Ann Epidemiol. 2003;13:606-12. http://dx.doi.org/10.1016/S1047-2797(03)00061-9
Atkinson J, Heaton R, Patterson T, Wolfson T, Deutsch R, Brown S, Summers J, Sciolla A, Guiterrez R, Ellis R, Abramson I, Hesselink J, McCutchan J, Grant I. Two-year prospective study of major depressive disorder in HIV-infected men. J Affect Disorders. 2007;108:225-34. http://dx.doi.org/10.1016/j.jad.2007.10.017
Baillargeon J, Paar D, Wu H, Giordano T, Murray O, Raimer B, Avery E, Diamond P, Pulvino J. Psychiatric disorders, HIV infection and HIV/hepatitis coinfection in the correctional setting. AIDS Care. 2008;20(1):124-9. http://dx.doi.org/10.1080/09540120701426532
Gupta R, Dandu M, Packel L, Rutherford G, Leiter K, Phaladze N, Korte F, Iacopino V, Weiser S. Depression and HIV in Botswana: A Population-Based Study on Gender-Specific Socioeconomic and Behavioral Correlates. PLoS One. 2010;5(12):e14252. http://dx.doi.org/10.1371/journal.pone.0014252
Leserman J, Pence B, Whetten K, Mugavero M, Thielman N, Swartz M, Stangle D. Relation of Lifetime Trauma and Depressive Symptoms to Mortality in HIV. Am J Psychiatry. 2007;164:1707-13. http://dx.doi.org/10.1176/appi.ajp.2007.06111775
Schlebusch L, Vawda N. HIV-infection as a self-reported risk fator for attempted suicide in South Africa. Afr J Psychiatry. 2010;13:280-3. http://dx.doi.org/10.4314/ajpsy.v13i4.61877
Nduna M, Jewkes R, Dunkle K, Shai N, Colman I. Associations between depressive symptoms, sexual behaviour and relationship characteristics: a prospective cohort study of young women and men in the Eastern Cape, South Africa. J Int Aids Soc. 2010;13:44. http://dx.doi.org/10.1186/1758-2652-13-44
Olisah O, Baiyewu O, Sheikh T. Adherence to highly ative antiretroviral therapy in depressed patients with HIV/AIDS attending a Nigerian university teaching hospital clinic. Afr J Psychiatry. 2010;13:275-9. http://dx.doi.org/10.4314/ajpsy.v13i4.61876
Glover D, Garcia-Acarena E, Lester P, Rice E, Rothram-Borus M. Stress Biomarkers as Outcomes for HIV+ Prevention: Participation, Feasibility and Findings Among HIV+ Latina and African American Mothers. AIDS Behav. 2009;14:339-50. http://dx.doi.org/10.1007/s10461-009-9549-7
Vaz-Serra, A., & Abreu, J. Aferição dos quadros clínicos depressivos I: Ensaio de aplicação do "Inventário Depressivo de Beck" a uma amostra portuguesa de doentes deprimidos. Coimbra Médica. 1973;20:623-44.
Maia A. Modelos de avaliação da experiência depressiva. Psiquiatria Clínica. 2001;22(2):197-204.
Ribeiro J. Avaliação em Psicologia da Saúde: instrumentos publicados em português. 1ª edição. Quarteto editor: Coimbra; 2007.
Centers for Disease Control and Prevention. Appendix B: Comparison of the revised world health organization and surveillance case definitions and staging sydtems for HIV infection [Internet]. 2008 [updated 2008 November 20; cited 2011 December 20]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a3.htm
Ministério da Saúde. Depressão [Internet]. 2006 [updated 2006 January 02; cited 2011 December 19]. Available from: http://www.portaldasaude.pt/portal/conteudos/enciclopedia+da+saude/ministeriosaude/saude+mental/depressao.htm?wbc_purpose=basic
Caramona M, Esteves A, Gonçalves J, Macedo T, Mendonça J, Osswald W, Pinheiro R, Rodrigues A, Sampaio C, Sepodes B, Teixeira A. Sistema Nervoso Central, In: Prontuário Terapêutico – 9, INFARMED/Ministério da Saúde. Lisboa: Ministério da Saúde; 2010. p.142-3.