Understanding mental health difficulties and associated psychosocial outcomes in adolescents in the HIV clinic at Kenyatta National Hospital, Kenya.
Understanding mental health difficulties and associated psychosocial outcomes in adolescents in the HIV clinic at Kenyatta National Hospital, Kenya.
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DOI：
10.1186/s12991-018-0200-8
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发表时间：
2018
影响因子：
3.7
通讯作者：
Nduati R
中科院分区：
文献类型：
--
作者：
Gaitho D;Kumar M;Wamalwa D;Wambua GN;Nduati R
在全球范围内，青少年的艾滋病毒发病率和与艾滋病有关的死亡率继续呈上升趋势。青春期身体的快速发育、性成熟以及认知和心理的巨大而缓慢的变化之间的相互作用，可能部分地解释了这一趋势。我们的主要目的是强调艾滋病毒感染的青少年的关键心理社会特征，并探讨这些特征是否与抑郁症状有关。从2016年8月至12月，在获得知情同意后，肯雅塔国立医院的艾滋病毒感染者青少年接受了采访，使用家庭环境，教育和就业，活动，性，自杀和抑郁特征（HEADSS）工具结合患者健康问卷（PHQ-9），以阐明抑郁症的关键症状以及与HEADSS上映射的心理社会特征的联系。为了确定哪些心理社会特征与抑郁症风险有关，将有症状的青少年的特征与未使用单变量和多变量回归分析的青少年的特征进行了比较。所有270名参与研究的青少年都接受了报名。年龄10-19岁，平均年龄14.75岁，男性占53.7%（n = 145）。总体而言，269人（99.9%）仍在上学，52.6%的青少年有抑郁症状。年龄在15-19岁是抑郁症的独立预测因素[OR = 2.34（95%CI 1.36，4.04）P < 0.02]，曾留级[OR = 1.74（95%CI 1.0-3.05）P = 0.05]，曾因学费不足而被送离学校[OR = 1.71（95% CI 1.0-2.91）P = 0.05]和不依从药物治疗[OR = 1.84（95% CI 1.08-3.14）P = 0.03。因食物不安全而缺餐与抑郁风险增加的重要趋势相关[OR = 2.42（CI 0.96-6.14）P = 0.06]。在接受采访的青少年中，每两个人中就有一个人有抑郁症状，这些症状与缺乏学费、缺饭、不坚持服药和滥用药物密切相关。
Globally adolescents continue to have an upward trend in HIV incidence and AIDS-related mortality. The interplay between the rapid physical growth, sexual maturation, and enormous albeit slow-evolving cognitive and psychological changes in adolescence may partly explain this trend. Our main purpose was to highlight key psychosocial characteristics of HIV-infected adolescents and explore if these characteristics are associated with depression symptoms. From August to December 2016 after obtaining informed consent, adolescents living with HIV at Kenyatta National Hospital were interviewed using the Home environment, Education and Employment, Activity, Sexuality, Suicide and depression traits (HEADSS) tool combined with the Patient Health Questionnaire (PHQ-9) to elucidate which key symptoms of depression and link with psychosocial characteristics mapped on HEADSS. In order to determine which psychosocial characteristics were linked with risk of depression, the traits of adolescents who were symptomatic were compared to those who were not using univariate and multivariate regression analysis. All the 270 adolescents offered participation in the study accepted to enroll. The aged 10–19 years were recruited and mean age was 14.75 and 53.7% (n = 145) were males. Overall, 269 (99.9%) were still in school and 52.6% of the adolescents had symptoms of depression. The independent predictors of depression were being of ages 15–19 years [OR = 2.34 (95% CI 1.36, 4.04) P < 0.02], ever repeating classes [OR = 1.74 (95% CI 1.0–3.05) P = 0.05], ever being sent away from school due to lack of school fees [OR = 1.71 (95% CI 1.0–2.91) P = 0.05], and non-adherence to medication [OR = 1.84 (95% CI 1.08–3.14) P = 0.03. Missing of meals due to food insecurity was associated with an important trend towards increased risk of depression [OR = 2.42 (CI 0.96–6.14) P = 0.06]. One in two of the adolescents interviewed had depression symptoms which were significantly associated with lack of school fees, missing meals, non-adherence to medication, and substance abuse.
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