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Published in: Archives of Women's Mental Health 3/2010

01-06-2010 | Original Contribution

Depression in women living with HIV: clinical and psychosocial correlates

Authors: Valeria A. Mello, Aluisio A. Segurado, Andre Malbergier

Published in: Archives of Women's Mental Health | Issue 3/2010

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Abstract

The number of Brazilian women living with HIV has increased significantly in past years, rendering studies of their particular care demands including psychiatric issues. This study measures the prevalence of major depression, using the Structured Clinical Interview for DSM-IV Axis I Disorders, in a sample of 120 women living with HIV in treatment at a reference centre in São Paulo. Socio-demographic variables, HIV-related clinical and laboratory data, including CD4+ cell counts and HIV plasma viral loads, as well as psychosocial features (intimate relationships, disclosure of HIV serostatus, partner’s serostatus and patient’s emotional and financial support) were investigated as factors potentially associated with depression. The prevalence of major depression at the time of evaluation was 25.8% (95% CI 18.2–33.4%). Clinical status (p = 0.002), lack of emotional support (p = 0.02), use of antidepressants (p = 0.028) and length of time since HIV diagnosis (p = 0.05) were associated with major depression in univariate analysis. In multivariate multiple-regression model, HIV clinical status, lack of emotional support and higher plasma viral loads were associated with depression. Sixty per cent of the women have a major depression diagnosis during lifetime. We conclude that major depression is highly prevalent among women living with HIV, but it is still underdiagnosed and undertreated.
Literature
go back to reference Anastos K, Gange SJ, Lau B, Weiser B, Detels R, Giorgi JV et al (2000) Association of race and gender with HIV-1 RNA levels and immunologic progression. J Acquir Immune Defic Syndr 24:218–226PubMed Anastos K, Gange SJ, Lau B, Weiser B, Detels R, Giorgi JV et al (2000) Association of race and gender with HIV-1 RNA levels and immunologic progression. J Acquir Immune Defic Syndr 24:218–226PubMed
go back to reference Andrade LH, Walters EE, Gentil V, Laurenti R (2002) Prevalence of ICD-10 mental disorders in a catchment area in the city of São Paulo. Brazil. Soc Psychiatr Epidemiol 37:316–325CrossRef Andrade LH, Walters EE, Gentil V, Laurenti R (2002) Prevalence of ICD-10 mental disorders in a catchment area in the city of São Paulo. Brazil. Soc Psychiatr Epidemiol 37:316–325CrossRef
go back to reference Beck AT, Ward CH (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed Beck AT, Ward CH (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed
go back to reference Boletim Epidemiológico Do Ministério Da Saúde (2008) Programa Nacional de Doenças Sexualmente Transmissíveis/AIDS. www.aids.gov.br. Boletim Epidemiológico Do Ministério Da Saúde (2008) Programa Nacional de Doenças Sexualmente Transmissíveis/AIDS. www.​aids.​gov.​br.
go back to reference Brito VOC, Parra D, Facchini R, Buchala CM (2007) HIV infection, hepatitis B and C and syphilis in homeless people, in the city of São Paulo, Brazil. Rev Saúde Pública Suppl 2(41):47–56 Brito VOC, Parra D, Facchini R, Buchala CM (2007) HIV infection, hepatitis B and C and syphilis in homeless people, in the city of São Paulo, Brazil. Rev Saúde Pública Suppl 2(41):47–56
go back to reference Brown GR, Rundell Jr (1993) A prospective study of psychiatric aspects of early HIV disease in women. Gen Hosp Psychiatry 15:139–147CrossRefPubMed Brown GR, Rundell Jr (1993) A prospective study of psychiatric aspects of early HIV disease in women. Gen Hosp Psychiatry 15:139–147CrossRefPubMed
go back to reference Carrieri MP, Leport C, Protopopescu C et al (2006) Factors associated with no adherence to highly active antiretroviral therapy: 5 year follow-up analyses with correction for bias induced by missing data in the treatment maintenance phase. J Acquir Immune Defic Syndr 41:477–485CrossRefPubMed Carrieri MP, Leport C, Protopopescu C et al (2006) Factors associated with no adherence to highly active antiretroviral therapy: 5 year follow-up analyses with correction for bias induced by missing data in the treatment maintenance phase. J Acquir Immune Defic Syndr 41:477–485CrossRefPubMed
go back to reference Centers for Disease Control and Prevention (1993) HIV/AIDS. Surveillance Report, 5 (2) Centers for Disease Control and Prevention (1993) HIV/AIDS. Surveillance Report, 5 (2)
go back to reference Chung JY, Magraw MM (1992) A group approach to psychosocial issues faced by HIV-positive women. Hosp Community Psychiatry 43(9):891–894PubMed Chung JY, Magraw MM (1992) A group approach to psychosocial issues faced by HIV-positive women. Hosp Community Psychiatry 43(9):891–894PubMed
go back to reference Ciesla JA, Roberts JE (2001) Meta-Analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry 158:725–730CrossRefPubMed Ciesla JA, Roberts JE (2001) Meta-Analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry 158:725–730CrossRefPubMed
go back to reference Cruess DG, Douglas SD, Petitto JM et al (2003) Association of depression, CD8+ T lymphocytes, and natural killer cell activity: implications for morbidity and mortality in human immunodeficiency virus disease. Curr Psychiatric Rep 5:445–450CrossRef Cruess DG, Douglas SD, Petitto JM et al (2003) Association of depression, CD8+ T lymphocytes, and natural killer cell activity: implications for morbidity and mortality in human immunodeficiency virus disease. Curr Psychiatric Rep 5:445–450CrossRef
go back to reference Egede LE (2007) Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resources utilization, lost productivity and functional disability. Gen Hosp Psychiatry 29(5):409–416CrossRefPubMed Egede LE (2007) Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resources utilization, lost productivity and functional disability. Gen Hosp Psychiatry 29(5):409–416CrossRefPubMed
go back to reference Evans DL, Ten Have TR, Douglas SD et al (2002) Association of depression with viral load, CD8 T lymphocytes and natural killer cells in women with HIV infection. Am J Psychiatry 159:1752–1759CrossRefPubMed Evans DL, Ten Have TR, Douglas SD et al (2002) Association of depression with viral load, CD8 T lymphocytes and natural killer cells in women with HIV infection. Am J Psychiatry 159:1752–1759CrossRefPubMed
go back to reference Ferrando SJ, Rabkin JG, Moore GM, Rabkin R (1999) Antidepressant treatment of depression in HIV-seropositive women. J Clin Psychiatry 60:741–746PubMed Ferrando SJ, Rabkin JG, Moore GM, Rabkin R (1999) Antidepressant treatment of depression in HIV-seropositive women. J Clin Psychiatry 60:741–746PubMed
go back to reference Fleck MP, Chaves ML, Poirier-Litté MF, Bourdel MC, Loo H, Guelfi JD (2004) Depression in France and Brazil: factorial structure of 17- item hamilton depression scale in inpatients. J Nerv Ment Dis 192:103–110CrossRefPubMed Fleck MP, Chaves ML, Poirier-Litté MF, Bourdel MC, Loo H, Guelfi JD (2004) Depression in France and Brazil: factorial structure of 17- item hamilton depression scale in inpatients. J Nerv Ment Dis 192:103–110CrossRefPubMed
go back to reference Gorestein C, Andrade L (1996) Validation of a portuguese version of the beck depression inventory and the state-trait anxiety inventory in brazilian subjects. Braz J Med Biol Res 29:453–457 Gorestein C, Andrade L (1996) Validation of a portuguese version of the beck depression inventory and the state-trait anxiety inventory in brazilian subjects. Braz J Med Biol Res 29:453–457
go back to reference Hamilton M (1960) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296 Hamilton M (1960) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296
go back to reference Hewitt RG, Parsa N, Gugino L (2001) The role of gender in HIV progression. AIDS Read 11(1):29–33PubMed Hewitt RG, Parsa N, Gugino L (2001) The role of gender in HIV progression. AIDS Read 11(1):29–33PubMed
go back to reference Kaplan MS, Marks G, Mertens SB (1997) Distress and coping among women with HIV infection. Preliminary findings from a multiethnic sample. Am J Orthopsychiatry 67:80–91CrossRefPubMed Kaplan MS, Marks G, Mertens SB (1997) Distress and coping among women with HIV infection. Preliminary findings from a multiethnic sample. Am J Orthopsychiatry 67:80–91CrossRefPubMed
go back to reference Kremer H, Sonnenberg-Schwan U, Arendt G, Brockmeyer NH, Potthoff A, Ulmer A, Graefe K, Lorenzen T, Starke W, Walker UA, German Competence Network HIV/AIDS (2009) HIV or HIV-therapy? Causal attributions of symptoms and their impact on treatment decisions among women and men with HIV. Eur J Med Res 14(4):139–146PubMed Kremer H, Sonnenberg-Schwan U, Arendt G, Brockmeyer NH, Potthoff A, Ulmer A, Graefe K, Lorenzen T, Starke W, Walker UA, German Competence Network HIV/AIDS (2009) HIV or HIV-therapy? Causal attributions of symptoms and their impact on treatment decisions among women and men with HIV. Eur J Med Res 14(4):139–146PubMed
go back to reference Leserman J, Petitto JM, Perkins DO, Folds JD, Golden RN, Evans DL (1997) Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men. Arch Gen Psychiatry 54:279–285PubMed Leserman J, Petitto JM, Perkins DO, Folds JD, Golden RN, Evans DL (1997) Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men. Arch Gen Psychiatry 54:279–285PubMed
go back to reference Lovisi GM, Morgado AF (1996) Suporte Social e Distúrbios Psiquiátricos em Mulheres infectadas pelo HIV. J Bras Psiquiatr 45:593–599 Lovisi GM, Morgado AF (1996) Suporte Social e Distúrbios Psiquiátricos em Mulheres infectadas pelo HIV. J Bras Psiquiatr 45:593–599
go back to reference McDaniel JS, Fowlie E, Summerville MB (1995) An assessment of rates of psychiatric morbidity and functioning in HIV disease. Gen Hosp Psychiatry 17:346–352CrossRefPubMed McDaniel JS, Fowlie E, Summerville MB (1995) An assessment of rates of psychiatric morbidity and functioning in HIV disease. Gen Hosp Psychiatry 17:346–352CrossRefPubMed
go back to reference Miller G, Cohen S, Herbert TB (1999) Pathways linking major depression and immunity in ambulatory female patients. Psychosom Med 61:850–860PubMed Miller G, Cohen S, Herbert TB (1999) Pathways linking major depression and immunity in ambulatory female patients. Psychosom Med 61:850–860PubMed
go back to reference Mocroft A, Gill MJ, Davidson W, Philips AN (2000) Are there gender differences in starting protease inhibitors, HAART, and disease progression despite equal access to care? J Acquir Immune Defic Syndr 24(5):475–482PubMed Mocroft A, Gill MJ, Davidson W, Philips AN (2000) Are there gender differences in starting protease inhibitors, HAART, and disease progression despite equal access to care? J Acquir Immune Defic Syndr 24(5):475–482PubMed
go back to reference Morrison MF, Petitto JM, Have TT et al (2002) Depressive and anxiety disorders in women with HIV infection. Am. J. Psychiatry 159:789–796CrossRefPubMed Morrison MF, Petitto JM, Have TT et al (2002) Depressive and anxiety disorders in women with HIV infection. Am. J. Psychiatry 159:789–796CrossRefPubMed
go back to reference Nogueira CL, Bonolo PF, Crosland GMD (2006) Anxiety and depression assessment prior to initiating antiretroviral treatment in Brazil. AIDS Care 18(6):529–536CrossRef Nogueira CL, Bonolo PF, Crosland GMD (2006) Anxiety and depression assessment prior to initiating antiretroviral treatment in Brazil. AIDS Care 18(6):529–536CrossRef
go back to reference Penzac SR, Reddy S, Grimsley SR (2002) Depression in patients with HIV infection. Am J Health-Syst Pharm 57:376–386 Penzac SR, Reddy S, Grimsley SR (2002) Depression in patients with HIV infection. Am J Health-Syst Pharm 57:376–386
go back to reference Remien RH, Exner T, Kertzner RM, Ehrhardt AA, Totheram-Borus MJ, Johnson MO, Weinhardt LS, Kittel LE, Goldstein RB, Pinto RM, Morim SF, Chesney MA, Lighfoot M, Gore-Felton C, Dodge B, Kelly JA (2006) Depressive symptomatology among HIV-positive women in the era of HAART: a stress and coping model. Am Community Psychol 38(3–4):275–285CrossRef Remien RH, Exner T, Kertzner RM, Ehrhardt AA, Totheram-Borus MJ, Johnson MO, Weinhardt LS, Kittel LE, Goldstein RB, Pinto RM, Morim SF, Chesney MA, Lighfoot M, Gore-Felton C, Dodge B, Kelly JA (2006) Depressive symptomatology among HIV-positive women in the era of HAART: a stress and coping model. Am Community Psychol 38(3–4):275–285CrossRef
go back to reference Riley ED (2007) Poverty, unstable housing, and HIV infection among women living in the United States. Curr HIV/AIDS Rep 4:181–186CrossRefPubMed Riley ED (2007) Poverty, unstable housing, and HIV infection among women living in the United States. Curr HIV/AIDS Rep 4:181–186CrossRefPubMed
go back to reference Spitzer RL, Williams JBW, Gibbon M (1995) Structured Clinical Interview for DSM-IV. American Psychiatric Press, Washington Spitzer RL, Williams JBW, Gibbon M (1995) Structured Clinical Interview for DSM-IV. American Psychiatric Press, Washington
go back to reference Schleifer SJ, Keller SE, Bartlett JA (1999) Depression and immunity: clinical factors and therapeutic course. Psychiatric Res 85:63–69CrossRef Schleifer SJ, Keller SE, Bartlett JA (1999) Depression and immunity: clinical factors and therapeutic course. Psychiatric Res 85:63–69CrossRef
go back to reference Tostes MA, Chalub M, Botega NJ (2004) The quality of life of HIV-infected women is associated with psychiatric morbidity. AIDS Care 16:177–186CrossRefPubMed Tostes MA, Chalub M, Botega NJ (2004) The quality of life of HIV-infected women is associated with psychiatric morbidity. AIDS Care 16:177–186CrossRefPubMed
go back to reference Turner BJ, Laine C, Cosler L, Hauck WW (2003) Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. J Gen Int Med 18:248–257CrossRef Turner BJ, Laine C, Cosler L, Hauck WW (2003) Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. J Gen Int Med 18:248–257CrossRef
go back to reference Zaharia MD, Ravindran AV, Griffiths J, Merali Z, Anisman H (2000) Lymphocyte proliferation among major depressive and dysthymic patients with typical or atypical features. J Affect Disord 58:1–10CrossRefPubMed Zaharia MD, Ravindran AV, Griffiths J, Merali Z, Anisman H (2000) Lymphocyte proliferation among major depressive and dysthymic patients with typical or atypical features. J Affect Disord 58:1–10CrossRefPubMed
Metadata
Title
Depression in women living with HIV: clinical and psychosocial correlates
Authors
Valeria A. Mello
Aluisio A. Segurado
Andre Malbergier
Publication date
01-06-2010
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 3/2010
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-009-0094-1

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