Factors associated with risk of depression and relevant predictors of screening for depression in clinical practice: a cross‐sectional study among HIV‐infected individuals in Denmark

Abstract

ObjectivesDepression and psychiatric disorders are frequent among HIV-infected individuals. The aim of this study was to determine the prevalence of depression and describe the psychiatric history of HIV-infected individuals in an out-patient clinic in Denmark and to identify factors of clinical importance that may be used to identify patients at risk of depression. MethodsIn 2013, 212 HIV-infected patients were included in a questionnaire study. We used the Beck Depression Inventory II (BDI-II) to assess the prevalence and severity of depressive symptoms. Patients with a BDI-II score ≥ 20 were offered a clinical evaluation by a consultant psychiatrist. Logistic regression was used to determine predictors associated with risk of depression. ResultsSymptoms of depression (BDI-II score ≥ 14) were observed in 75 patients (35%), and symptoms of moderate to major depression (BDI-II score ≥ 20) in 55 patients (26%). There was also a high prevalence of co-occurring mental illness. In a multivariate model, self-reported stress, self-reported perception that HIV infection affects all aspects of life, self-reported poor health, not being satisfied with one's current life situation, previous alcohol abuse, nonadherence to antiretroviral therapy and previously having sought help because of psychological problems were independently associated with risk of depression. ConclusionsSymptoms of depression and co-occurring mental illness are under-diagnosed and under-treated among HIV-infected individuals. We recommend that screening of depression should be conducted regularly to provide a full psychiatric profile to decrease the risk of depression and improve adherence and quality of life in this population. [21] found that the risk of depression in individuals with a psychiatric history prior to their HIV infection, particularly a history of depression, was higher compared with patients with no previous psychiatric history. They concluded that it is possible that a history of psychiatric disease can predict future vulnerability [21]. The elevated depression rates observed after the onset of the HIV infection may therefore reflect new episodes of pre-existing disorders rather than new-onset depression. The importance of these findings was emphasized by a Danish study where 54.5% of the Danish HIV-infected cohort compared with 29.2% of the control group had used at least one prescription for a psychotropic drug during the study period; the consumption of psychotropic drugs increased after being diagnosed with HIV infection [22].The aim of this study was to investigate the prevalence of depression and psychiatric history among HIV-infected individuals in an out-patient clinic at Odense University Hospital in Denmark and to determine which factors were relevant in clinical practice to identify those at risk of depression. Methods Study populationFrom March 2013 to June 2013, all HIV-infected patients (n = 472) attending the Department of Infectious Diseases at Odense University Hospital, Odense, Denmark were recruited to the study....

Prevalence and factors associated with depressive symptoms in individuals living with HIV/AIDS

“…In this study, 42.3% of the individuals living with HIV/AIDS had depressive symptoms (BDI > 11). This finding corroborates a study carried out in Denmark, which presents a prevalence of 35% (Slot, Sodemann, Gabel, Holmskov, Laursen & Rodkjaer, 2015). The various instruments used to assess depressive symptoms and the different cut-off points authors adopt for the BDI (Sherr, Clucas, Harding, Sibley & Catalan, 2011) may explain this variation.…”

Associação entre percepção de doença e ansiedade, depressão e autoeficácia em pessoas com HIV/Aids

“…Segundo Sale (2014), pessoas que apresentam uma percepção de doença negativa são mais propensas a desenvolver depressão. De maneira semelhante ao presente estudo, Slot et al (2015) identifi caram alguns fatores associados ao risco de depressão em pessoas infectadas pelo HIV, entre eles: percepção de que o HIV afeta todos os aspectos da vida (ou seja, percepção de consequências impostas pela doença) e problemas emocionais associados ao diagnóstico de soropositividade, como estresse. Assim, as correlações entre depressão e percepção de doença observadas nesse estudo parecem coerentes, tendo em vista que a percepção de piores consequências associadas ao HIV/aids, preocupações exacerbadas com a enfermidade e efeitos relevantes no estado emocional estiveram associados a maior número de sintomas depressivos.…”

“…Cabe ressaltar, que a depressão é uma das alterações psiquiátricas mais comuns em pessoas infectadas pelo HIV (Christo & Paula, 2008;Ministério da Saúde, 2012;Seidl & Faustino, 2014;Slot et al, 2015). Contudo, há grande variação na prevalência desse transtorno psicológico em pessoas que vivem com HIV/ aids, com resultados que variam de 0 a 45%, sendo os dados desse estudo superiores àqueles apontados pela literatura (46,4%).…”

Depression as a risk factor for HIV infection

“…In addition to hastening HIV disease progression and mortality, depression further may facilitate viral transmission contributing to a cycle of reinforcement between depression and HIV illness [13]. Thus, screening of depression should be conducted regularly to provide a full psychiatric profile to decrease the risk of depression and improve quality of life in this population [34]. Social support for HIV-infected patients that includes treatment for depression and substance abuse is likely to pay dividends in the form of lower non-AIDS mortality [35].…”