A Comparison of Clinical Features of Depressed and Non-Depressed People Living with HIV/AIDS, in Nigeria, West Africa

Abstract

Objectives: Depressive disorders are a significant public health issue. They are prevalent, disabling, and often chronic, with a high economic burden to the society. Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 4 times higher than the general population. It’s still questionable whether HIV related depression is clinically different from sero-positive patients without depression. Studies comparing the clinical features of depressed and non-depressed People Living with HIV/AIDs are limited, hence the need for this study. Methods: This was a hospital based, cross sectional, descriptive study of three hundred adult HIV/AIDS patients attending the HIV clinic of Kwara State specialist hospital, Sobi, Ilorin. The PHQ-9 was administered to the respondents to screen for depression. A pre-tested PHQ-9 questionnaire was used to collect data. Subject who scored one and more were assessed clinically for depression. The three keys of social determinants of depression (SDS) were assessed and the association with depression sought. Results: One hundred and seventy (56.7%) satisfied the criteria for a depressive disorder using the PHQ-9 score. Compared to non-depressed sero-positive patients, depressed HIV patients were more likely to be female, single, unemployed, with below average year of schooling, low social economic status, low social cohesion and more stressful life events. They are more prone to hopelessness, thought of taking life and plan to commit suicide. Conclusion: These findings, show that the clinical and associated features of depression differ between depressed and non-depressed sero-positive subjects, thus requiring different management.

Share and Cite:

R. Shittu, B. Issa, G. Olanrewaju, A. Mahmoud, S. Aderibigbe and L. Odeigah, "A Comparison of Clinical Features of Depressed and Non-Depressed People Living with HIV/AIDS, in Nigeria, West Africa," Open Journal of Medical Psychology, Vol. 3 No. 1, 2014, pp. 60-69. doi: 10.4236/ojmp.2014.31008.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] World Health Organization, “Depression,” 2011. http://www.who.int/mentalhealth/management/depression/definition/en/
[2] Centers for Disease Control and Prevention, “Depression: The Public Health Dimension-Feature-Findings Fall,” 2005. http://www.sph.umich.edu/newsevents/findings/fall05/features/one.htm
[3] J. U. Ohaeri and R. O. Jegede, “Depression and the General Medical Practitioner in Nigeria,” Medicare, Vol. 6, 1991, pp. 7-11.
[4] P. Cassano and M. Fava, “Depression and Public Health: An Overview,” Journal of Psychosomatic Research, Vol. 53, No. 4, 2002, pp. 849-857. http://dx.doi.org/10.1016/S0022-3999(02)00304-5
[5] F. Starace, A. Ammassari, M. P. Trotta, R. Murri, P. De Longis, C. Izzo, et al., “Depression Is a Risk Factor for Suboptimal Adherence to Highly Active Antiretroviral Therapy,” Journal of Acquired Immune Deficiency Syndromes, Vol. 31, No. 3, 2002, pp. 136-139. http://dx.doi.org/10.1097/00126334-200212153-00010
[6] J. A. Ciesla and J. E. Roberts, “Meta-Analysis of the Relationship between HIV Infection and Risk for Depressive Disorders,” American Journal of Psychiatry, Vol. 158, No. 5, 2001, pp. 725-730. http://dx.doi.org/10.1176/appi.ajp.158.5.725
[7] M. F. Morrison, J. M. Petitto, H. T. Ten, D. R. Gettes, M. S. Chiappini, A. L. Weber, et al., “Depressive and Anxiety Disorders in Women with HIV Infection,” American Journal of Psychiatry, Vol. 159, No. 5, 2012, pp. 789-796. http://dx.doi.org/10.1176/appi.ajp.159.5.789
[8] J. H. Arnsten, P. A. Demas, R. W. Grant, M. N. Gourevitch, H. Farzadegan, A. A. Howard, et al., “Impact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV-Infected Drug Users,” Journal of General Internal Medicine, Vol. 17, No. 5, 2002, pp. 377-381.
[9] L. M. Bogart, J. M. Boarts, E. M. Sledjeski and D. L. Delahanty, “The Differential Impact of PTSD and Depression on HIV Disease Markers and Adherence to HAART in People Living with HIV,” AIDS and Behavior, Vol. 10, No. 3, 2006, pp. 253-261. http://dx.doi.org/10.1007/s10461-006-9069-7
[10] A. D. Bouhnik, M. Preau, E. Vincent, M. P. Carrieri, H. Gallais, G. Lepeu, et al., “Depression and Clinical Progression in HIV-Infected Drug Users Treated with Highly Active Antiretroviral Therapy,” Antiretroviral Therapy, Vol. 10, No. 1, 2005, pp. 53-61.
[11] R. Vilhjalmsson, “Life Stress, Social Support and Clinical Depression; a Reanalysis of the Literature,” Social Science & Medicine, Vol. 37, No. 3, 1993, pp. 331-342. http://dx.doi.org/10.1016/0277-9536(93)90264-5
[12] D. W. L. Lai and H. M. Tong, “Comparison of Social Status Determinants of Depressive Symptoms among Elderly Chinese in Guangzhou, Hong King,” Asian Journal of Gerontology & Geriatrics, Vol. 4, No. 2, 2009, pp. 58-65.
[13] L. N. Robins and D. A. Reiger, “Psychiatric Disorders in America: The Epidemiologic Catchment Area Study,” The free Press, New York, 1991.
[14] US Preventive Task Force, “Screening for Depression in Adults: Recommendation Statement,” American Family Physician, Vol. 82, No. 8, 2010, pp. 976-979.
[15] R. C. Kessler, K. A. Mcgonagle, S. Y. Zhao, C. B. Nelson, M. E. Hughes, S. Shleman, et al., “Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United-States-Results from the National-Comorbidity-Survey,” Archives of General Psychiatry, Vol. 51, No. 1, 1994, pp. 8-19. http://dx.doi.org/10.1001/archpsyc.1994.03950010008002
[16] S. B. Pattern, “Incidence of major depression in Canada,” Canadian Medical Association Journal, Vol. 163, No. 6, 2000, pp. 714-715.
[17] D. R. Offord, M. H. Boyle, D. Campbell, P. Goering, E. Lin, M. Wong, Y. A. Racine, et al., “One Year Prevalence of Psychiatric Disorder in Ortarians 15 to 64 Years of Age,” Canadian Journal of Psychiatry, Vol. 41, 1996, pp. 559-563.
[18] S. B. Pattern, J. L. Wang, J. V. Williams, S. Currie, C. A. Beck, C. J. Maxwell, et al., “Descriptive Epidemiology of Major Depression in Canada,” Canadian Journal of Psychiatry, Vol. 51, No. 2, 2006, pp. 84-90.
[19] T. J. Wade, J. Cairney and D. J. Pevalin, “Emergence of Gender Differences in Depression during Adolescence: National Panel Results from Three Countries,” Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 41, No. 2, 2002, pp. 90-198. http://dx.doi.org/10.1097/00004583-200202000-00013
[20] V. Lorant, D. Deliege, W. Eaton, A. Robert, P. Phillippot and M. Ansseau, “Socio Economical Inequalities in Depression: A Meta-Analysis,” American Journal of Epidemiology, Vol. 157, No. 2, 2003, pp. 98-112. http://dx.doi.org/10.1093/aje/kwf182
[21] E. Goode, “Deviant Behavior,” Prentice Hall, Upper Saddle River, 1997.
[22] Canada, “HIV/AIDS and Health Determinants: Lessons for Coordinating Policy and Action,” Houses of Commons Standing Committee on Health, Ottawa, 1996.
[23] Canada, “Legacy Discussion Paper,” Health Canada, Ottwa, 2000.
[24] G. William, A. N. Paul, J. K. Kelly, J. W. James, F. Tillman, S. Luide, et al., “Does the Family APGAR Effectively Measure Family Functioning?” The Journal of Family Practice, Vol. 50, No. 1, 2001, pp. 1-10.
[25] M. O. Araoye, “Data collection in: Research Methodology with Statistics for Health and Social Sciences,” Nathadex Publishers, Ilorin, 2003, pp. 130-159.
[26] A. C. Ndu, S. U. Arinze, E. N. Aguwa and I. E. Obio, “Prevalence of Depression and Role of Support Group in Its Management: A Study of Adult HIV/AIDS Patients Attending HIV/AIDS Clinic in a Tertiary Health Facility in South-Eastern Nigeria,” Journal of Public Health and Epidemiology, Vol. 3, No. 4, 2011, pp. 182-186.
[27] K. Krooenke, R. L. Sptzer and B. Williams, “The Patient Health Questionnaire 2: Validity of a Two-Item Depression Screener,” Medical Care, Vol. 41, No. 11, 2003, pp. 1284-1294. http://dx.doi.org/10.1097/01.MLR.0000093487.78664.3C
[28] R. L. Spitzer, J. B. Williams, K. Kroenke, M. Linzer, F. V. deGruy 3rd, S. R. Hahn, et al., “Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care. The PRIME-MD 1000 Study,” Journal of the American Medical Association, Vol. 272, No. 22, 1994, pp. 1749-1756. http://dx.doi.org/10.1001/jama.1994.03520220043029
[29] K. Kroenke, R. L. Spitzer and J. B. W. Williams, “The PHQ-9: Validity of a Brief Depression Severity Measure,” Journal of General Internal Medicine, Vol. 16, No. 9, 2001, pp. 606-613. http://dx.doi.org/10.1046/j.1525-1497.2001.016009606.x
[30] World Health Organization (WHO), “A Comceptual Framework for Action on the Social Determinants of Health,” 2010. http://whqlibdoc.who.int/publications/20109789241500852_eng.pdf
[31] D. E. Stewart, “Social Determinants of Women’s Mental Health,” Journal of Psychosomatic Research, Vol. 63, No. 3, 2007, pp. 223-224. http://dx.doi.org/10.1016/j.jpsychores.2007.07.002
[32] M. R. Phillips, G. H. Yang, Y. P. Zhang, L. J. Wang and H. Y. Ji, “Risk Factors for Suicide in China: A National Case-Control Psychological Autopsy Study,” Lancet, Vol. 360, No. 9347, 2002, pp. 1728-1736. http://dx.doi.org/10.1016/S0140-6736(02)11681-3
[33] S. Gabriel, “The Family APGAR: A Proposal for a Family Function Test and Its Use by Physicians,” The Journal of Family Practice, Vol. 6, No. 6, 1978, pp. 1231-1239.
[34] R. Hill, “Generic Features of Families Under Stress,” Social Casework, Vol. 39, 1958, pp. 139-141.
[35] B. Pence, S. Reil, K. Whetten, J. Leserman, D. Stangl, M. Swartz, et al., “Minorities, the Poor and Survivors of Abuse: HIV-Infected Patients in the US Deep South,” Southern Medical Journal, Vol. 100, No. 11, 2007, pp. 1114-1122. http://dx.doi.org/10.1097/01.smj.0000286756.54607.9f
[36] E. G. Bing, M. A. Burnam, D. Longshore, et al., “Psychiatric Disorders and Drug Abuse among Human Immuno-deficiency Virus-Infected Adults in the United States,” JAMA, Vol. 58, No. 8, 2001, pp. 721-728. http://dx.doi.org/10.1001/archpsyc.58.8.721
[37] S. M. Asch, A. M. Kibourne, A. L. Gifford, M. A. Burnam, B Turner, M. F. Shapiro, et al., “For the HCSUS Consortium, under Diagnosis of Depression in HIV,” Journal of General Internal Medicine, Vol. 18, No. 6, 2003, pp. 450-460. http://dx.doi.org/10.1046/j.1525-1497.2003.20938.x
[38] I. K. Igie and M. Udoh, “Prevalence of Depression in HIV/AIDS Patients, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria,” International AIDS Society: 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention, Rome, 17-20 July 2011.
[39] S. Shehu and G. Muktar, “Prevalence and Factors Associated with Depression in HIV/AIDS Patients Aged 15-25 Years at Aminu Kano Teaching Hospital, Nigeria,” Journal of Child and Adolescent Mental Health, Vol. 20, No. 2, 2008, pp. 95-99. http://dx.doi.org/10.2989/JCAMH.2008.20.2.5.688
[40] T. Bongongo, J. Tunbo and I. Govender, “Depressive Features among Adult Patients Receiveing Antiretroviral Therapy for HIV in Rustenburg District, South Africa,” South African Journal of Psychiatry, Vol. 19, No. 2, 2013, pp. 31-34. http://dx.doi.org/10.7196/sajp.418
[41] K. Rajdeep and K. Ramadeep, “A Comparison of Clinical Features among Patients Suffering from Depression in HIV Positive and HIV Negative Cases,” Delhi Psychiatry Journal, Vol. 15, No. 1, 2012, pp. 160-164.
[42] M. Averina, O. Nilssen, T. Bren, J. Brox, V. L. Arhipovsky and A. G. Kalinin, “Social and Lifestyle Determinants of Depression, Anxiety, Sleeping Disorders and Self-Evaluated Quality of Life in Russia Population Based Study in Arkhangelsk,” Social Psychiatry and Psychiatric Epidemiology, Vol. 40, No. 7, 2005, pp. 511-518. http://dx.doi.org/10.1007/s00127-005-0918-x
[43] M. Y. H. Mossa and F. Y. Jennah, “Treating Depression in HIV/AIDS,” South African Journal of Psychiatry, Vol. 13, No. 3, 2007, pp. 86-88.
[44] A. Komiti, “Depression in People Living with HIV/AIDS Attending Primary Care and Outpatient Clinics,” Australian & New Zealand Journal of Psychiatry, Vol. 37, No. 1, 2003, pp. 70-77. http://dx.doi.org/10.1046/j.1440-1614.2003.01118.x
[45] G. L. Klerman and M. Weissman, “Increasing Rate of Depression,” JAMA, Vol. 261, No. 15, 1989, pp. 2229-2235.
[46] A. Y. Zhan, L. C. Yu, J. Yuan, Z. Tong, C. Yang, S. E. Foreman, “Family and Cultural Correlates of Depression among Chinese Elderly,” International Journal of social Psychiatry, Vol. 43, No. 3, 1999, pp. 199-212. http://dx.doi.org/10.1177/002076409704300306
[47] B. Unnikrishnan, V. Jagannath, J. T. Ramapuram, B. Achappa and D. Madi, “Study of Depression and Its Associated Factors among Women Living with HIV/AIDS in Coastal South India,” ISRN AIDS, Vol. 2012, 2012, Article ID: 684972.
[48] O’Sullivan, “The Psychosocial Determinants of Depression: A Lifespan Perspective,” Journal of Nervous & Mental Disease, Vol. 192, No. 9, 2004, pp. 585-594. http://dx.doi.org/10.1097/01.nmd.0000138225.19549.dd
[49] J. Lesserman, B. W. Pence, K. Whetten, et al., “Relationship of Lifetime Trauma and Depressive Symptoms to Mortality in HIV,” American Journal of Psychiatry, Vol. 164, No. 11, 2007, pp. 1707-1713. http://dx.doi.org/10.1176/appi.ajp.2007.06111775
[50] O. N. Onya and P. C. Stanley, “Risk Factors for Depression Illness among Elderly Gopd Attendees at Upth,” Journal of Dental and Medical Sciences, Vol. 5, No. 2, 2013, pp. 77-86. http://dx.doi.org/10.9790/0853-0527786
[51] H. J. Stevenson and J. Akinster, “The Mcmaster Model of Family Functioning: Observer and Parental Ratings,” Family Process, Vol. 34, No. 3, 1995, pp. 337-347.
[52] R. J. Zalenski and R. Raspa, “Maslow’s Hierarchy of needs: A Framework for Achieving Human Potential in Hospice,” Journal of Palliative Medicine, Vol. 9, No. 5, 2006, pp. 1120-1127. http://dx.doi.org/10.1089/jpm.2006.9.1120
[53] C. L. Rich and B. S. Runeson, “Similarities in Diagnostic co Morbidity between Suicide among Young People in Sweden and the United States,” Acta Psychiatrica Scandinavica, Vol. 86, No. 5, 1992, pp. 335-339. http://dx.doi.org/10.1111/j.1600-0447.1992.tb03276.x

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.