Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study.
Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study.
复制标题
DOI：
10.1186/s12888-021-03079-4
复制
发表时间：
2021-02-10
期刊：
影响因子：
4.4
通讯作者：
Abubakar A
中科院分区：
文献类型：
--
作者：
Nyongesa MK;Mwangi P;Kinuthia M;Hassan AS;Koot HM;Cuijpers P;Newton CRJC;Abubakar A
在撒哈拉以南非洲，对艾滋病毒携带者(YLWH)的年轻人中抑郁和焦虑等常见精神障碍(CMD)的调查不足。为了弥补这一差距，在肯尼亚，我们：a)确定青年妇幼保健院与其未受感染的同龄人相比的慢性精神疾病的流行率；b)调查艾滋病毒状况，将其作为青年慢性精神疾病的独立预测指标；c)调查慢性精神疾病的风险和保护指标，更多地关注青少年儿童保健中心。2018年11月至2019年9月，从肯尼亚沿海的两个县招募了819名18-24 岁的年轻人(407名艾滋病毒感染者)。在其他问卷中，通过音频计算机辅助自我访谈进行了本地适应的先前存在的心理健康测量，患者健康问卷(9个条目)和广泛性焦虑障碍量表(7个条目)。采用Logistic回归分析CMDs的相关因素。与未感染的同龄人相比，青少年儿童医院的CMD患病率显著升高，即29%比12%；p <； 0.001抑郁症状，19%比8%；p <； 0.001焦虑症状，16%比5%；p <； 0.001抑郁和焦虑共病症状。HIV状态独立地预测抑郁症状及其与焦虑症状的共存。在YLWH中，负性生活事件、较高的HIV相关耻辱感和较低的抗逆转录病毒治疗依从性是CMDs升高的危险指标。在未感染艾滋病毒的年轻人中，父母双方的死亡是抑郁症状上升的风险指标。在感染和未感染艾滋病毒的青少年中，针对慢性精神分裂症的保护指标包括较高的社会支持和与健康相关的生活质量。在肯尼亚沿海，与未感染的同龄人相比，青少年儿童的CMD负担要高得多。在这种情况下，青年时期艾滋病毒呈阳性预示着更多的抑郁症状及其与焦虑症状的共病。在肯尼亚沿海地区，如果将慢性精神障碍的常规筛查纳入其护理方案中，肯尼亚沿海地区处于慢性精神疾病高危状态的青年妇女可以从早期发现、转诊和治疗中受益。通过继续提供支持，帮助失去艾滋病毒的年轻人接受他们的损失，可以改善他们的精神健康。在社区一级，加强社会资本或改善感染或未感染艾滋病毒的青少年的整体生活质量的方案可能有益于他们的心理健康。
In sub-Saharan Africa, common mental disorders (CMDs) like depression and anxiety are under-investigated amongst young people living with HIV (YLWH). To address the gap, in Kenya we: a) determined the prevalence of CMDs among YLWH compared to their uninfected peers; b) investigated HIV status as an independent predictor of CMDs in young people; c) investigated CMDs risk and protective indicators with more focus on YLWH. Between November 2018 and September 2019, 819 young people aged 18–24 years (407 HIV-infected) were recruited from two Counties on the Kenyan coast. Locally adapted pre-existing mental health measures, Patient Health Questionnaire (9-item) and Generalized Anxiety Disorder scale (7-item), were administered among other questionnaires via audio computer-assisted self-interview. Logistic regression was used to determine the correlates of CMDs. Prevalence of CMDs was significantly elevated among YLWH compared to their uninfected peers i.e. 29% vs. 12%; p < 0.001 for depressive symptoms, 19% vs. 8%; p < 0.001 for anxiety symptoms, and 16% vs. 5%; p < 0.001 for comorbid depressive and anxiety symptoms. HIV status independently predicted depressive symptoms and its co-occurrence with anxiety symptoms. Among YLWH, negative life events, higher perceived HIV-related stigma and low adherence to antiretroviral therapy were the risk indicators for elevated CMDs. Among HIV-uninfected youths, death of both parents was a risk indicator for elevated depressive symptoms. Protective indicators against CMDs among youths with and without HIV included higher social support and health-related quality of life. At the Kenyan coast, YLWH have significantly higher burden of CMDs compared to their uninfected peers. Being HIV-positive as a youth in this setting is predictive of more depressive symptoms and its comorbidity with anxiety symptoms. YLWH at high risk of CMDs in coastal Kenya can benefit from early detection, referral and treatment if routine screening for CMDs is integrated in their care package. The mental wellbeing of bereaving HIV-unaffected youths could be improved through continued support to help them come to terms with their loss. At the community level, programmes strengthening the social capital or improving the overall quality of life of youths with or without HIV may be beneficial to their mental health.
登录
查看更多内容
DOI：
10.1176/appi.ajp.2009.08081244
发表时间：
2009-07
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Brent D;Melhem N;Donohoe MB;Walker M
通讯作者：
Walker M
影响因子：
1.7
作者：
Abebe, Helina;Shumet, Shegaye;Abebaw, Dessie
通讯作者：
Abebaw, Dessie
影响因子：
6.6
作者：
Chibanda, Dixon;Verhey, Ruth;Abas, Melanie
通讯作者：
Abas, Melanie
影响因子：
3.7
作者：
Estes, Larissa J.;Lloyd, Linda E.;Glick, Nancy
通讯作者：
Glick, Nancy
影响因子：
3.7
作者：
Bernard C;Dabis F;de Rekeneire N
通讯作者：
de Rekeneire N