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BMC Psychiatry

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Open Access 01-12-2021 | HIV-Associated Dementia | Research

Depression and HIV associated neurocognitive disorders among HIV infected adults in rural southwestern Uganda: a cross-sectional quantitative study

Authors: Jane Kasozi Namagga, Godfrey Zari Rukundo, Vallence Niyonzima, Joachim Voss

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

HIV-Associated Neurocognitive Disorder (HAND remains a pronounced consequence of HIV/AIDS despite improved life expectancies. This is often associated with several dysfunctions such as decrease of attention, mood alterations and psychomotor disturbances. Many factors, including age, gender, employment status, and psychiatric disorders, have been associated with HAND. Among the associated psychiatric disorders, depression is often more prevalent. It can influence not only quality of life, relationships and employment but also adherence to medical care. We assessed the prevalence of depression and its association with HAND among people living with HIV in rural Southwestern Uganda.

Methods

This was a cross-sectional study that used Beck Depression Inventory-1 and International HIV Dementia Scale to assess depression and HAND respectively. We defined depression with a score of > 10 and HAND with a cutoff score of ≤10. We conducted data analysis using STATA version 12, and Pearson Chi-square test and logistic regression to determine associations between depression and HAND. The level of statistical significance was set at p ≤ 0.05. Ethical approval and administrative clearance were obtained from relevant bodies.

Results

Of the 393 participants assessed for depression and HAND, 27% had depression and 58.3% screened positive for HAND. All levels of depression were more prevalent among female participants. We found a significant association between depression and HIV associated neurocognitive disorders (χ2 (3) = 9.0538 p = 0.029).

Conclusion

Our findings confirmed a high prevalence of depression in individuals with HAND which is a major component of the disease burden.

UNAIDS, On the fast-track to end AIDS by 2030: focus on location and population URL: http://www.unaids.org/sites/default/files/media_asset.WAD2015_report_en_part01.pdf [accessed 2018-07-21] [WebCite Cache ID 715bIMFf2], 2015.

Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–33. https://doi.org/10.1016/S0140-6736(13)61809-7.CrossRefPubMedPubMedCentral

McArthur JC, Haughey N, Gartner S, Conant K, Pardo C, Nath A, et al. Human immunodeficiency virus-associated dementia: an evolving disease. J Neurovirol. 2003;9(2):205–21. https://doi.org/10.1080/13550280390194109.CrossRefPubMed

Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69(18):1789–99. https://doi.org/10.1212/01.WNL.0000287431.88658.8b.CrossRefPubMed

Haddow LJ, Floyd S, Copas A, Gilson RJC. A systematic review of the screening accuracy of the HIV dementia scale and international HIV dementia scale. PLoS One. 2013;8(4):e61826. https://doi.org/10.1371/journal.pone.0061826.CrossRefPubMedPubMedCentral

Namagga JK, Rukundo GZ, Voss JG. Prevalence and risk factors of HIV-associated neurocognitive disorders in rural southwestern Uganda. J Assoc Nurs AIDS Care. 2019;30(5):531–8. https://doi.org/10.1097/JNC.0000000000000036.CrossRef

Fialho RM, Pereira M, Mendonça N, Ouakinin S. Depressive symptoms and neurocognitive performance among HIV-infected women. Women Health. 2013;53(2):117–34. https://doi.org/10.1080/03630242.2013.767301.CrossRefPubMed

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: 2013.

World Health Organization. The International Statistical Classification of Diseases and Health-Related Problems ICD-10, Tenth Revision. Volume 1: Tabular List (Vol. 1). World Health Organization; 2004.

10.

Cross S, Önen N, Gase A, Overton ET, Ances BM. Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale. J NeuroImmune Pharmacol. 2013;8(5):1114–22. https://doi.org/10.1007/s11481-013-9505-1.CrossRefPubMedPubMedCentral

11.

Atkinson JH, Heaton RK, Patterson TL, Wolfson T, Deutsch R, Brown SJ, et al. Two-year prospective study of major depressive disorder in HIV-infected men. J Affect Disord. 2008;108(3):225–34. https://doi.org/10.1016/j.jad.2007.10.017.CrossRefPubMed

12.

Ickovics JR, Hamburger ME, Vlahov D, Schoenbaum EE, Schuman P, Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV epidemiology research study. Jama. 2001;285(11):1466–74. https://doi.org/10.1001/jama.285.11.1466.CrossRefPubMed

13.

Abas M, Ali GC, Nakimuli-Mpungu E, Chibanda D. Depression in people living with HIV in sub-Saharan Africa: time to act. Tropical Med Int Health. 2014;19(12):1392–6. https://doi.org/10.1111/tmi.12382.CrossRef

14.

Kingori C, Haile ZT, Ngatia P. Depression symptoms, social support and overall health among HIV-positive individuals in Kenya. Int J STD AIDS. 2015;26(3):165–72. https://doi.org/10.1177/0956462414531933.CrossRefPubMed

15.

Memiah P, Shumba C, Etienne-Mesubi M, Agbor S, Hossain MB, Komba P, et al. The effect of depressive symptoms and CD4 count on adherence to highly active antiretroviral therapy in sub-Saharan Africa. J Int Assoc Providers AIDS Care. 2014;13(4):346–52. https://doi.org/10.1177/2325957413503368.CrossRef

16.

Wroe EB, Hedt-Gauthier BL, Franke MF, Nsanzimana S, Turinimana JB, Drobac P. Depression and patterns of self-reported adherence to antiretroviral therapy in Rwanda. Int J STD AIDS. 2015;26(4):257–61. https://doi.org/10.1177/0956462414535206.CrossRefPubMed

17.

Nel A, Kagee A. The relationship between depression, anxiety and medication adherence among patients receiving antiretroviral treatment in South Africa. AIDS Care. 2013;25(8):948–55. https://doi.org/10.1080/09540121.2012.748867.CrossRefPubMed

18.

Rubaihayo J, Tumwesigye NM, Konde-Lule J. Trends in prevalence of selected opportunistic infections associated with HIV/AIDS in Uganda. BMC Infect Dis. 2015;15(1):1.CrossRef

19.

Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes O, et al. Higher frequency of dementia in older HIV-1 individuals the Hawaii aging with HIV-1 cohort. Neurology. 2004;63(5):822–7. https://doi.org/10.1212/01.WNL.0000134665.58343.8D.CrossRefPubMed

20.

Reynolds E. Benefits and risks of folic acid to the nervous system. J Neurol Neurosurg Psychiatry. 2002;72(5):567–71. https://doi.org/10.1136/jnnp.72.5.567.CrossRefPubMedPubMedCentral

21.

Katon WJ. Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biol Psychiatry. 2003;54(3):216–26. https://doi.org/10.1016/S0006-3223(03)00273-7.CrossRefPubMed

22.

McDowell I. Measuring health: a guide to rating scales and questionnaires. USA: Oxford University press; 2006.CrossRef

23.

Chan C-M, Tsoi MM. The BDI and stimulus determinants of cognitive-related depression among Chinese college students. Cogn Ther Res. 1984;8(5):501–7. https://doi.org/10.1007/BF01173287.CrossRef

24.

Andrade L, Gorenstein C, Vieira Filho AH, Tung TC, Artes R. Psychometric properties of the Portuguese version of the state-trait anxiety inventory applied to college students: factor analysis and relation to the Beck depression inventory. Braz J Med Biol Res. 2001;34(3):367–74. https://doi.org/10.1590/S0100-879X2001000300011.CrossRefPubMed

25.

Gorenstein C, Andrade L. Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29(4):453-7.

26.

Tusiime J, Bangsberg D, Mark W. Examining the psychometric properties of the Beck depression inventory-ii using an item response Modelling approach in an HIV infected population in Kampala, Uganda. J Depress Anxiety. 2015;4(184):2167–1044.1000184.

27.

Beck AT, et al. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561–71. https://doi.org/10.1001/archpsyc.1961.01710120031004.CrossRefPubMed

28.

Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77–100. https://doi.org/10.1016/0272-7358(88)90050-5.CrossRef

29.

Sacktor NC, Wong M, Nakasujja N, Skolasky RL, Selnes OA, Musisi S, et al. The international HIV dementia scale: a new rapid screening test for HIV dementia. Aids. 2005;19(13):1367–74.PubMed

30.

Nakku J, Kinyanda E, Hoskins S. Prevalence and factors associated with probable HIV dementia in an African population: a cross-sectional study of an HIV/AIDS clinic population. BMC Psychiatry. 2013;13(1):1.CrossRef

31.

Kagee A, Martin L. Symptoms of depression and anxiety among a sample of south African patients living with HIV. AIDS Care. 2010;22(2):159–65. https://doi.org/10.1080/09540120903111445.CrossRefPubMed

32.

Passos SMK, Souza LDDM, Spessato BC. High prevalence of suicide risk in people living with HIV: who is at higher risk? AIDS Care. 2014;26(11):1379–82. https://doi.org/10.1080/09540121.2014.913767.CrossRefPubMed

33.

Silveira MPT, Guttier MC, Pinheiro CAT, Pereira TVS, Cruzeiro ALS, Moreira LB. Depressive symptoms in HIV-infected patients treated with highly active antiretroviral therapy. Braz J Psychiatry. 2012;34(2):162–7. https://doi.org/10.1590/S1516-44462012000200008.CrossRefPubMed

34.

Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust. 2009;190(S7):S54–60. https://doi.org/10.5694/j.1326-5377.2009.tb02471.x.CrossRefPubMed

35.

Ford DE, Erlinger TP. Depression and C-reactive protein in US adults: data from the third National Health and nutrition examination survey. Arch Intern Med. 2004;164(9):1010–4. https://doi.org/10.1001/archinte.164.9.1010.CrossRefPubMed

36.

Cyranowski JM, Frank E, Young E, Shear MK. Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch Gen Psychiatry. 2000;57(1):21–7. https://doi.org/10.1001/archpsyc.57.1.21.CrossRefPubMed

37.

Gillies GE, McArthur S. Estrogen actions in the brain and the basis for differential action in men and women: a case for sex-specific medicines. Pharmacol Rev. 2010;62(2):155–98. https://doi.org/10.1124/pr.109.002071.CrossRefPubMedPubMedCentral

38.

Young Y, Frick KD, Phelan EA. Can successful aging and chronic illness coexist in the same individual? A multidimensional concept of successful aging. J Am Med Dir Assoc. 2009;10(2):87–92. https://doi.org/10.1016/j.jamda.2008.11.003.CrossRefPubMed

39.

Vance DE, et al. Successful aging and the epidemiology of HIV. Clin Interv Aging. 2011;6:181.CrossRef

40.

Johnsson G. Management of mental health disorders in HIV-positive patients: by the southern African HIV clinicians society. S Afr J HIV Med. 2013;14(4):155–66.CrossRef

41.

Nyirenda M, Chatterji S, Rochat T, Mutevedzi P, Newell ML. Prevalence and correlates of depression among HIV-infected and-affected older people in rural South Africa. J Affect Disord. 2013;151(1):31–8. https://doi.org/10.1016/j.jad.2013.05.005.CrossRefPubMedPubMedCentral

42.

So-Armah K, Gupta SK, Kundu S, Stewart JC, Goulet JL, Butt AA, et al. Depression and all-cause mortality risk in HIV-infected and HIV-uninfected US veterans: a cohort study. HIV Med. 2019;20(5):317–29. https://doi.org/10.1111/hiv.12726.CrossRefPubMedPubMedCentral

43.

Skinner S, Adewale AJ, DeBlock L, Gill MJ, Power C. Neurocognitive screening tools in HIV/AIDS: comparative performance among patients exposed to antiretroviral therapy. HIV Med. 2009;10(4):246–52. https://doi.org/10.1111/j.1468-1293.2008.00679.x.CrossRefPubMed

44.

Belete T, Medfu G, Yemiyamrew E. Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder referral hospital. Ethiop J Health Sci. 2017;27(1):67–76. https://doi.org/10.4314/ejhs.v27i1.9.CrossRefPubMedPubMedCentral

45.

Lawler K, Mosepele M, Seloilwe E, Ratcliffe S, Steele K, Nthobatsang R, et al. Depression among HIV-positive individuals in Botswana: a behavioral surveillance. AIDS Behav. 2011;15(1):204–8. https://doi.org/10.1007/s10461-009-9622-2.CrossRefPubMedPubMedCentral

Title: Depression and HIV associated neurocognitive disorders among HIV infected adults in rural southwestern Uganda: a cross-sectional quantitative study
Authors: Jane Kasozi Namagga
Godfrey Zari Rukundo
Vallence Niyonzima
Joachim Voss
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: HIV-Associated Dementia
Mood Disorders
HIV-Associated Dementia
Human Immunodeficiency Virus
Affective Disorder
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03316-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Depression and HIV associated neurocognitive disorders among HIV infected adults in rural southwestern Uganda: a cross-sectional quantitative study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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