The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review.

The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review.
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DOI:
10.1007/s10461-012-0212-3
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发表时间:
2012-11
期刊:
影响因子:
4.4
通讯作者:
Azar, Marwan M.
Azar, Marwan M.
中科院分区:
医学2区
文献类型:
--
作者:
Springer, Sandra A.;Dushaj, Azem;Azar, Marwan M.

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这是对 82 项已发表研究的系统回顾,这些研究调查了 DSM-IV 精神障碍对艾滋病毒/艾滋病患者 (PLWHA) 联合抗逆转录病毒治疗 (cART) 依从性和持续性的影响。 62 篇文章研究了抑郁症,其中 58% (N = 32/62) 发现 cART 依从性和持久性较低。十七篇文章研究了一种或多种焦虑症,其中大多数发现与 cART 依从性或持续性没有关联。 80% 的研究评估了精神病 (N = 3)、躁郁症 (N = 5) 和人格障碍 (N = 2) 对 cART 依从性和持久性的影响,也发现没有关联。评估抗抑郁治疗 (ADT) 对 cART 依从性影响的 9 项研究中,有 7 项 (78%) 发现改善。研究中依从性和抑郁症的测量结果存在显着差异;共同的研究测量将改善数据的协调。还需要更多专门针对抑郁症以外的其他精神障碍对 cART 依从性的影响的研究,以及评估 ADT 对 cART 依从性的随机对照试验。本文的在线版本 (doi:10.1007/s10461-012-0212-3) 包含补充材料,可供授权用户使用。
This is a systematic review of eighty-two published studies investigating the impact of DSM-IV mental disorders on combination antiretroviral therapy (cART) adherence and persistence among persons living with HIV/AIDS (PLWHA). Sixty-two articles examined depression, with 58 % (N = 32/62) finding lower cART adherence and persistence. Seventeen articles examined one or more anxiety disorders, with the majority finding no association with cART adherence or persistence. Eighty percent of the studies that evaluated the impact of psychotic (N = 3), bipolar (N = 5) and personality disorders (N = 2) on cART adherence and persistence also found no association. Seven out of the nine studies (78 %) evaluating the impact of antidepressant treatment (ADT) on cART adherence found improvement. Adherence and depression measurements varied significantly in studies; common research measurements would improve data harmonization. More research specifically addressing the impact of other mental disorders besides depression on cART adherence and RCTs evaluating ADT on cART adherence are also needed. The online version of this article (doi:10.1007/s10461-012-0212-3) contains supplementary material, which is available to authorized users.
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