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People living with HIV need help for their mental health, too

Tristan Manalac
16 Sep 2020

People living with HIV (PLWHIV) commonly suffer from depression and anxiety, as well as worse health-related quality of life (HRQOL), according to a recent study.

“Physicians should not only focus on the antiviral treatment of these patients but also monitor their mental status, especially that of younger patients. For PLWHIV with depression and anxiety, psychological intervention should be provided, and social role rebuilding may be good for depression and anxiety alleviation,” researchers said.

The 121 PLWHIV participants (mean age, 31.4±10.64 years; 65.3 percent male) showed a higher average depression score than the 61 healthy controls (mean age, 33.66±10.95 years; 67.2 percent male) enrolled (47.83±10.58 vs 36.52±9.69; p<0.001). Depression was measured using the Self-Rating Depression Scale (SDS). [Patient Prefer Adherence 2020;14:1533-1540]

Similarly, mean anxiety scores, measured using the Self-Rating Anxiety Scale (SAS), were significantly elevated in PLWHIV participants than in controls (41.06±11.24 vs 32.31±7.99; p<0.001). Overall, 43.0 percent (n=52) of PLWHIV were diagnosed with depression, and 23.1 percent (n=28) were diagnosed with anxiety.

Multivariate logistic regression analysis revealed that age was a significant, independent, and inverse predictor of both depression (odds ratio [OR], 0.929, 95 percent confidence interval [CI], 0.884–0.977; p=0.004) and anxiety (OR, 0.890, 95 percent CI, 0.816–0.970; p=0.008), indicating that these psychological morbidities may be exacerbated in younger PLWHIVs.

Smoking was also a risk factor for depression (OR, 4.297, 95 percent CI, 1.837–10.046; p=0.001), while alcohol consumption was correlated with anxiety (OR, 4.801, 95 percent CI, 1.772–13.003; p=0.002).

In turn, PLWHIVs who had depression or anxiety also suffered from a heavier burden of psychological symptoms, such as hostility, paranoia ideation, bad appetite, and poor sleep quality, among others.

HRQOL likewise suffered in PLWHIVs with depression or anxiety. For instance, physiological and mental health QOL were worse in those with depression, while PLWHIVs with anxiety showed worse vitality, social functioning, and mental health. However, multivariate analysis revealed that only depression was a significant predictor of poor HRQOL (OR, 0.370; p=0.001).

“Based on our results, we confirmed that the incidence of depression is high in populations infected with HIV,” the researchers said. “We further found that this clinical dilemma is more prominent in young patients. Moreover, The higher the level of depression in HIV patients, the poorer their level of HRQOL.”

The present findings indicate that in PLWHIVs, psychosocial interventions are treatment hallmarks that are just as important as controlling the virus and boosting the immune system.

“Poor HRQOL and poor psychological conditions may induce poor treatment adherence, which in turn will induce relapse and resistance of virus,” the researchers pointed out. “It is interesting [to see] whether improving the patient’s depression level can increase the HRQOL of PLWHIV. However, it still needs further exploration.”

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Pearl Toh, 22 Oct 2020
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