Depression as a major impact on the quality of life of HIV-positive Brazilians

Abstract

Given that mental symptoms might interfere with the quality of life (QOL) of people living with HIV/AIDS (PLHAs), the goal of this paper was to examine the correlation between depression, anxiety, and QOL in a sample of HIV-positive Brazilians. A cross-sectional study was designed to analyze the correlations between the presence of mental symptoms and the QOL scores of PLHAs. Depression and anxiety symptoms were measured using the Beck Depression Inventory and the State-Trait Anxiety Inventory, respectively. The QOL was assessed using the World Health Organization Quality of Life instrument - HIV module. A convenience sample of 308 men and women living with HIV (131 asymptomatic, 91 symptomatic, and 86 with AIDS) in Porto Alegre/RS-Brazil was selected. The depression scores were higher in patients with AIDS compared with asymptomatic and symptomatic patients, yet there were no differences in the anxiety scores between the stages of infection. Better QOL scores were observed in the earlier stages of infection (asymptomatic and symptomatic groups). In the correlation between mental symptoms and QOL scores, the Pearson's coefficient values were of a moderate (r = .47) to a large (r = .65) magnitude for depressive symptoms, and the scores for the anxiety symptoms were small to moderate (r ≤ .35). After adjusting for the disease stage and clinical and sociodemographic variables in a multiple regression model (using QOL as the dependent variable), the depressive symptoms showed significantly higher beta-coefficient values compared with the remaining variables. The data obtained from this study indicate that the QOL of PLHAs is primarily affected by depression. Thus, it has been strongly recommended that treatment programs dedicated to PLHAs assess depressive symptoms, providing subsequent referrals and treatments. Treating depression might be effective for PLHAs and might potentially improve both the overall QOL and the health outcomes.

Assessment of factors associated with the quality of life of patients living with HIV/HCV co-infection

“…Across multiple studies, findings regarding the link between immunological status and QoL have been mixed (for a review, see Degroote, Vogelaers, & Vandijck, 2014). In our study, biological markers were associated with QoL, but these associations were limited to the functional aspects of QoL, as previously reported (Zimpel & Fleck, 2014). …”

“…As expected, the strongest and most consistent factor associated with reduced QoL was depressive symptoms. These findings highlight the important link between more symptoms of psychological distress and lower QoL among patients with these infectious diseases (Ballester-Arnal et al, 2015;Fontana et al, 2002;Liu et al, 2006;Marcellin et al, 2007;Zimpel & Fleck, 2014). Psychological symptoms have been recognised as interfering with activities of daily life, physical functioning, emotional regulation and interpersonal relationships.…”

“…Although many studies have reported mixed findings, there is some consistency regarding the associations between poorer QoL and female gender (Chandra et al, 2009;Degroote et al, 2013;Pereira & Canavarro, 2011), older age Préau et al, 2007b;Skevington, 2012), living alone or not having a stable partner (Degroote et al, 2013;Préau et al, 2007b), lower education (da Silva et al, 2013;Liu et al, 2006), 5 unemployment or lack of work activity (Fleming et al, 2004;Liu et al, 2006;Rueda et al, 2011), and IDU (Degroote et al, 2013;Préau et al, 2007b). Regarding clinical variables, lower CD4+ T-cell (CD4 for short) count (Canavarro & Pereira, 2012;Hays et al, 2000;Safren et al, 2012), and advanced HIV stages Ruiz Perez et al, 2005;Zimpel & Fleck, 2014) have also been associated with lower QoL. Similarly, among HCV patients, QoL has also been associated with demographic variables (Strauss & Teixeira, 2006), although the results of the studies that have examined these associations are mixed.…”

Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature

“…Results indicated that anxiety symptoms significantly predicted a lower QuoL. Zimpel and Fleck (2014) found similar results when examining a cross-sectional sample of 308 PLWHA in Brazil wherein trait anxiety significantly predicted lower quality of life. A more recent study conducted in the US utilizing cross-sectional data from a larger trial indicated that anxiety symptoms predicted physical functioning and role functioning among a sample of 108 HIV+ intravenous drug uses (Psaros, O’Cleirigh, Bullis, Markowitz, & Safren, 2013).…”

Improving Depression Among HIV-Infected Adults: Transporting the Effect of a Depression Treatment Intervention to Routine Care

“…1,2 For PLWH, depression is a debilitating condition that negatively affects quality of life, 3,4 antiretroviral (ART) adherence 5-7 and viral suppression. 8-10 Antidepressant medications are effective at treating severe depression in HIV-infected adults.…”