Psychological distress symptoms of individuals seeking HIV-related psychosocial support in western Kenya

Abstract

While researchers in many western countries have documented the nature of psychological distress that is commonly present among individuals living with HIV, there has been virtually no research on the same topic among other high prevalence areas of the world, particularly in countries like Kenya. This study sought to document the nature of psychological distress among 397 individuals living with HIV in western Kenya and who were participating in psychosocial support groups in conjunction with their enrollment in HIV-related treatment. Psychological distress was assessed using the Brief Symptom Inventory (BSI), a 53-item self-report psychological inventory that asks individuals to recall symptoms experienced in the prior seven days. The levels of psychological distress in this sample were moderate with a substantial proportion of participants meeting the criteria that suggested a need for further psychiatric evaluation. Findings support the need for further assessments of the range and nature of psychological distress among the diverse communities of countries like Kenya and the need for greater attention to the inclusion of mental health services in the rapidly developing treatment and prevention programs in this region of the world.

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

“…To investigate this counterintuitive result for males, a result consistent with our report on psychological distress 30 , we accounted for confounding covariates by using the ANCOVA model in the previous paragraph after removing the AIDS diagnosis (because it was correlated with the CD4 count); the interaction was not significant, and the adjusted mean PHQ-9 score was 7.0 and 6.7 for a CD4 count <200 and ≥200, respectively (p=0.78), revealing very little relationship between the CD4 count and depression, but a trend in the anticipated direction (e.g., 97 ) for the entire sample regardless of gender.…”

“…PHQ-2 ≥3 demonstrated high sensitivity (85%) and specificity (95%) for diagnosing any PHQ-9 depressive disorder (AUC, 0.97), and 91% and 77%, respectively, for diagnosing PHQ-9 MDD (AUC, 0.91). Psychometrics were also good within four gender/age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) subgroups.CONCLUSIONS: PHQ-9 and PHQ-2 appear valid/ reliable for assessing DSM-IV depressive disorders and depression severity among adults living with HIV/AIDS in western Kenya. …”

“…With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .…”

“…With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .Depression in sub-Saharan Africa presents in forms (culturespecific idioms, somatic, based on interpersonal relationships or spiritual in nature) that may obscure detection [36][37][38] . However, depression exists at possibly higher prevalence rates than in western countries 37 according to 16 studies 4,5,7,[9][10][11][38][39][40][41][42][43][44][45][46][47] , and an additional 13 studies cited in 37 , of community and non-HIVspecific clinic populations, with generally higher rates for women than men 37,…”

Routine Screening for Depression: Identifying a Challenge for Successful HIV Care

“…2 It is well documented that individuals with HIV have significantly higher levels of psychological distress than the general population and are impacted by fluctuating levels of distress throughout the course of HIV infection. [3][4][5][6] During periods of distress, individuals with a chronic illness not only have lower quality of life, but also have more difficulty engaging in behaviors that are health promoting. [7][8][9] There has been little documented that examined the effect highly active antiretroviral therapy (HAART) on depression among individuals with HIV.…”