Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Symptoms of common mental disorder and cognitive associations with seropositivity among a cohort of people coming for testing for HIV/AIDS in Goa, India: a cross-sectional survey

Authors: Rosie Mayston, Vikram Patel, Melanie Abas, Priya Korgaonkar, Ramesh Paranjape, Savio Rodrigues, Martin Prince

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

The majority of research on HIV/AIDS and mental health has been carried out among clinical populations: the time of onset of comorbid depression and the mechanisms for this are therefore unclear. Although there is evidence to suggest that asymptomatic people living with HIV/AIDS exhibit some cognitive deficits, the prevalence of poor cognitive functioning among people in low income settings at an early, pre-clinical stage has not yet been investigated.

Methods

We used a cross-sectional survey design to test the hypotheses that symptoms of Common Mental Disorder (CMD) and low scores on cognitive tests would be associated with seropositivity among participants coming for testing for HIV/AIDS. Participants were recruited at the time of coming for testing for HIV/AIDS; voluntary informed consent was sought for participation in research interviews and data linkage with HIV test results. Baseline questionnaires including sociodemographic variables and measures of mental health (PHQ-9, GAD-7, panic disorder questions, AUDIT and delayed word list learning and recall and animal naming test of verbal fluency) were administered by trained interviews. HIV status data was extracted from clinical records.

Results

CMD and scoring below the educational norm on the test of verbal fluency were associated with testing positive for HIV/AIDS in bivariate analysis (OR = 2.26, 1.31-3.93; OR = 1.77, 1.26-2.48, respectively). After controlling for the effects of confounders, the association between CMD and seropositivity was no longer statistically significant (AOR = 1.56, 0.86-2.85). After adjusting for the effects of confounders, the association between low scores on the test of verbal fluency and seropositivity was retained (AOR = 1.77, 1.27-2.48).

Conclusions

Our findings provide tentative evidence to suggest that low cognitive test scores (and possibly depressive symptoms) may be associated with HIV status among people who have yet to receive their HIV test results. Impaired cognitive functioning and depression-like symptoms may be the result of the same underlying neurological damage. CMD and cognitive impairment may overlap to a greater extent than previously assumed. If replicated, this may have implications for the way in which we measure and treat CMD and cognitive functioning among people living with HIV/AIDS.
Literature
1.
Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, Turner BJ, Eggan F, Beckman R, Vitiello B: Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001, 58 (8): 721-728. 10.1001/archpsyc.58.8.721.CrossRefPubMed
2.
Ciesla JA, Roberts JE: Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001, 158 (5): 725-730. 10.1176/appi.ajp.158.5.725.CrossRefPubMed
3.
Gupta R, Dandu M, Packel L, Rutherford G, Leiter K, Phaladze N, Korte FP, Iacopino V, Weiser SD: Depression and HIV in Botswana: a population-based study on gender-specific socioeconomic and behavioral correlates. PLoS One. 2010, 5 (12): e14252-10.1371/journal.pone.0014252.CrossRefPubMedPubMedCentral
4.
Nakasujja N, Skolasky RL, Musisi S, Allebeck P, Robertson K, Ronald A, Katabira E, Clifford DB, Sacktor N: Depression symptoms and cognitive function among individuals with advanced HIV infection initiating HAART in Uganda. BMC Psychiatry. 2010, 10: 44-10.1186/1471-244X-10-44.CrossRefPubMedPubMedCentral
5.
Nakimuli-Mpungu E, Musisi S, Katabira E, Nachega J, Bass J: Prevalence and factors associated with depressive disorders in an HIV + rural patient population in southern Uganda. J Affect Disord. 2011, 135 (1–3): 160-167.CrossRefPubMed
6.
Sahay S, Phadke M, Brahme R, Paralikar V, Joshi V, Sane S, Risbud A, Mate S, Mehendale S: Correlates of anxiety and depression among HIV test-seekers at a voluntary counseling and testing facility in Pune, India. Qual Life Res. 2007, 16 (1): 41-52. 10.1007/s11136-006-9112-1.CrossRefPubMed
7.
Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K: Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health. 2008, 8: 265-10.1186/1471-2458-8-265.CrossRefPubMedPubMedCentral
8.
Peltzer K, Friend-du Preez N, Ramlagan S, Anderson J: Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa. BMC Public Health. 2010, 10: 111-10.1186/1471-2458-10-111.CrossRefPubMedPubMedCentral
9.
Byakika-Tusiime J, Crane J, Oyugi JH, Ragland K, Kawuma A, Musoke P, Bangsberg DR: Longitudinal antiretroviral adherence in HIV + Ugandan parents and their children initiating HAART in the MTCT-Plus family treatment model: role of depression in declining adherence over time. AIDS Behav. 2009, 13 (Suppl 1): 82-91.CrossRefPubMed
10.
Antelman G, Kaaya S, Wei R, Mbwambo J, Msamanga GI, Fawzi WW, Fawzi MC: Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. J Acquir Immune Defic Syndr. 2007, 44 (4): 470-477. 10.1097/QAI.0b013e31802f1318.CrossRefPubMed
11.
Leserman J: HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry. 2003, 54 (3): 295-306. 10.1016/S0006-3223(03)00323-8.CrossRefPubMed
12.
Robertson K, Liner J, Heaton R: Neuropsychological assessment of HIV-infected populations in international settings. Neuropsychol Rev. 2009, 19 (2): 232-249. 10.1007/s11065-009-9096-z.CrossRefPubMedPubMedCentral
13.
Heaton RK, Grant I, Butters N, White DA, Kirson D, Atkinson JH, McCutchan JA, Taylor MJ, Kelly MD, Ellis RJ: The HNRC 500–neuropsychology of HIV infection at different disease stages. HIV Neurobehavioral Research Center. J Int Neuropsychol Soc. 1995, 1 (3): 231-251. 10.1017/S1355617700000230.CrossRefPubMed
14.
Wilkie FL, Goodkin K, Eisdorfer C, Feaster D, Morgan R, Fletcher MA, Blaney N, Baum M, Szapocznik J: Mild cognitive impairment and risk of mortality in HIV-1 infection. J Neuropsychiatry Clin Neurosci. 1998, 10 (2): 125-132.CrossRefPubMed
15.
Hinkin CH, Hardy DJ, Mason KI, Castellon SA, Durvasula RS, Lam MN, Stefaniak M: Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004, 18 (Suppl 1): S19-25.CrossRefPubMedPubMedCentral
16.
van Gorp WG, Baerwald JP, Ferrando SJ, McElhiney MC, Rabkin JG: The relationship between employment and neuropsychological impairment in HIV infection. J Int Neuropsychol Soc. 1999, 5 (6): 534-539.CrossRefPubMed
17.
Bonnet F, Amieva H, Marquant F, Bernard C, Bruyand M, Dauchy FA, Mercie P, Greib C, Richert L, Neau D: Cognitive disorders in HIV-infected patients: are they HIV-related?. AIDS. 2013, 27 (3): 391-400. 10.1097/QAD.0b013e32835b1019.CrossRefPubMed
18.
Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A: Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Transm Infect. 2007, 83 (1): 29-34.CrossRefPubMed
19.
Steward WT, Chandy S, Singh G, Panicker ST, Osmand TA, Heylen E, Ekstrand ML: Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from Southern India. Psychol Health Med. 2011, 16 (1): 74-85. 10.1080/13548506.2010.521568.CrossRefPubMedPubMedCentral
20.
Lawson MA, Kelley KW, Dantzer R: Intracerebroventricular administration of HIV-1 Tat induces brain cytokine and indoleamine 2,3-dioxygenase expression: a possible mechanism for AIDS comorbid depression. Brain Behav Immun. 2011, 25 (8): 1569-1575. 10.1016/j.bbi.2011.05.006.CrossRefPubMedPubMedCentral
21.
Maj M, Satz P, Janssen R, Zaudig M, Starace F, D’Elia L, Sughondhabirom B, Mussa M, Naber D, Ndetei D: WHO neuropsychiatric AIDS study, cross-sectional phase II. Neuropsychological and neurological findings. Arch Gen Psychiatry. 1994, 51 (1): 51-61. 10.1001/archpsyc.1994.03950010051007.CrossRefPubMed
22.
Rochat TJ, Richter LM, Doll HA, Buthelezi NP, Tomkins A, Stein A: Depression among pregnant rural South African women undergoing HIV testing. JAMA. 2006, 295 (12): 1376-1378. 10.1001/jama.295.12.1376.CrossRefPubMed
23.
Lawler K, Mosepele M, Ratcliffe S, Seloilwe E, Steele K, Nthobatsang R, Steenhoff A: Neurocognitive impairment among HIV-positive individuals in Botswana: a pilot study. J Int AIDS Soc. 2010, 13: 15-10.1186/1758-2652-13-15.CrossRefPubMedPubMedCentral
24.
Spitzer RL, Kroenke K, Williams JB: Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999, 282 (18): 1737-1744. 10.1001/jama.282.18.1737.CrossRefPubMed
25.
Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, Simon G, Weiss HA: Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med. 2008, 38 (2): 221-228.CrossRefPubMed
26.
Spitzer RL, Kroenke K, Williams JB, Lowe B: A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006, 166 (10): 1092-1097. 10.1001/archinte.166.10.1092.CrossRefPubMed
27.
Ustun TB, Goldberg D, Cooper J, Simon GE, Sartorius N: New classification for mental disorders with management guidelines for use in primary care: ICD-10 PHC chapter five. Br J Gen Pract. 1995, 45 (393): 211-215.PubMedPubMedCentral
28.
Kessler RC, Ormel J, Demler O, Stang PE: Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. J Occup Environ Med. 2003, 45 (12): 1257-1266. 10.1097/01.jom.0000100000.70011.bb.CrossRefPubMed
29.
Das-Munshi J, Goldberg D, Bebbington PE, Bhugra DK, Brugha TS, Dewey ME, Jenkins R, Stewart R, Prince M: Public health significance of mixed anxiety and depression: beyond current classification. Br J Psychiatry. 2008, 192 (3): 171-177. 10.1192/bjp.bp.107.036707.CrossRefPubMed
30.
Carey KB, Carey MP, Chandra PS: Psychometric evaluation of the alcohol use disorders identification test and short drug abuse screening test with psychiatric patients in India. J Clin Psychiatry. 2003, 64 (7): 767-774. 10.4088/JCP.v64n0705.CrossRefPubMedPubMedCentral
31.
Pal HR, Jena R, Yadav D: Validation of the alcohol use disorders identification test (AUDIT) in urban community outreach and de-addiction center samples in north India. J Stud Alcohol. 2004, 65 (6): 794-800.CrossRefPubMed
32.
D’Costa G, Nazareth I, Naik D, Vaidya R, Levy G, Patel V, King M: Harmful alcohol use in Goa, India, and its associations with violence: a study in primary care. Alcohol Alcohol. 2007, 42 (2): 131-137.CrossRefPubMed
33.
Gaunekar G, Patel V, Rane A: The impact and patterns of hazardous drinking amongst male industrial workers in Goa, India. Soc Psychiatry Psychiatr Epidemiol. 2005, 40 (4): 267-275. 10.1007/s00127-005-0886-1.CrossRefPubMed
34.
Nayak MB, Bond JC, Cherpitel C, Patel V, Greenfield TK: Detecting alcohol-related problems in developing countries: a comparison of 2 screening measures in India. Alcohol Clin Exp Res. 2009, 33 (12): 2057-2066. 10.1111/j.1530-0277.2009.01045.x.CrossRefPubMedPubMedCentral
35.
White DA, Taylor MJ, Butters N, Mack C, Salmon DP, Peavy G, Ryan L, Heaton RK, Atkinson JH, Chandler JL: Memory for verbal information in individuals with HIV-associated dementia complex. HNRC Group. J Clin Exp Neuropsychol. 1997, 19 (3): 357-366. 10.1080/01688639708403864.CrossRefPubMed
36.
Ganguli M, Seaberg EC, Ratcliff GG, Belle SH, DeKosky ST: Cognitive stability over 2 years in a rural elderly population: the MoVIES project. Neuroepidemiology. 1996, 15 (1): 42-50. 10.1159/000109888.CrossRefPubMed
37.
Prince M, Acosta D, Chiu H, Scazufca M, Varghese M: Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet. 2003, 361 (9361): 909-917. 10.1016/S0140-6736(03)12772-9.CrossRefPubMed
38.
Kinyanda E, Hoskins S, Nakku J, Nawaz S, Patel V: Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda. BMC Psychiatry. 2011, 11: 205-10.1186/1471-244X-11-205.CrossRefPubMedPubMedCentral
39.
Marwick KF, Kaaya SF: Prevalence of depression and anxiety disorders in HIV-positive outpatients in rural Tanzania. AIDS Care. 2010, 22 (4): 415-419. 10.1080/09540120903253981.CrossRefPubMed
40.
Cohen MH, Fabri M, Cai X, Shi Q, Hoover DR, Binagwaho A, Culhane MA, Mukanyonga H, Karegeya DK, Anastos K: Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women. J Womens Health (Larchmt). 2009, 18 (11): 1783-1791. 10.1089/jwh.2009.1367.CrossRef
41.
Patel V, Kirkwood BR, Pednekar S, Weiss H, Mabey D: Risk factors for common mental disorders in women. Population-based longitudinal study. Br J Psychiatry. 2006, 189: 547-555. 10.1192/bjp.bp.106.022558.CrossRefPubMed
42.
Patel V, Pereira J, Coutinho L, Fernandes R, Fernandes J, Mann A: Poverty, psychological disorder and disability in primary care attenders in Goa, India. Br J Psychiatry. 1998, 172: 533-536. 10.1192/bjp.172.6.533.CrossRefPubMed
43.
Skinner D, Mfecane S: Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa. SAHARA J. 2004, 1 (3): 157-164. 10.1080/17290376.2004.9724838.CrossRefPubMed
44.
Rahangdale L, Banandur P, Sreenivas A, Turan JM, Washington R, Cohen CR: Stigma as experienced by women accessing prevention of parent-to-child transmission of HIV services in Karnataka, India. AIDS Care. 2010, 22 (7): 836-842. 10.1080/09540120903499212.CrossRefPubMedPubMedCentral
45.
Piot P, Greener R, Russell S: Squaring the circle: AIDS, poverty, and human development. PLoS Med. 2007, 4 (10): 1571-1575.CrossRefPubMed
46.
Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW: From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008, 9 (1): 46-56. 10.1038/nrn2297.CrossRefPubMedPubMedCentral
47.
Safren SA, Thomas BE, Mimiaga MJ, Chandrasekaran V, Menon S, Swaminathan S, Mayer KH: Depressive symptoms and human immunodeficiency virus risk behavior among men who have sex with men in Chennai, India. Psychol Health Med. 2009, 14 (6): 705-715. 10.1080/13548500903334754.CrossRefPubMedPubMedCentral
48.
Hoare J, Fouche JP, Spottiswoode B, Joska JA, Schoeman R, Stein DJ, Carey PD: White matter correlates of apathy in HIV-positive subjects: a diffusion tensor imaging study. J Neuropsychiatry Clin Neurosci. 2010, 22 (3): 313-320. 10.1176/appi.neuropsych.22.3.313.CrossRefPubMed
49.
Sikkema KJ, Watt MH, Meade CS, Ranby KW, Kalichman SC, Skinner D, Pieterse D: Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa. J Acquir Immune Defic Syndr. 2011, 57 (3): 230-237. 10.1097/QAI.0b013e3182167e7a.CrossRefPubMedPubMedCentral
50.
Iudicello JE, Woods SP, Parsons TD, Moran LM, Carey CL, Grant I: Verbal fluency in HIV infection: a meta-analytic review. J Int Neuropsychol Soc. 2007, 13 (1): 183-189.CrossRefPubMed
51.
Gupta JD, Satishchandra P, Gopukumar K, Wilkie F, Waldrop-Valverde D, Ellis R, Ownby R, Subbakrishna DK, Desai A, Kamat A: Neuropsychological deficits in human immunodeficiency virus type 1 clade C-seropositive adults from South India. J Neurovirol. 2007, 13 (3): 195-202. 10.1080/13550280701258407.CrossRefPubMed
52.
Yepthomi T, Paul R, Vallabhaneni S, Kumarasamy N, Tate DF, Solomon S, Flanigan T: Neurocognitive consequences of HIV in southern India: a preliminary study of clade C virus. J Int Neuropsychol Soc. 2006, 12 (3): 424-430.CrossRefPubMed
53.
Uekermann J, Daum I, Schlebusch P, Wiebel B, Trenckmann U: Depression and cognitive functioning in alcoholism. Addiction. 2003, 98 (11): 1521-1529. 10.1046/j.1360-0443.2003.00526.x.CrossRefPubMed
54.
Fromme K, D’Amico EJ, Katz EC: Intoxicated sexual risk taking: an expectancy or cognitive impairment explanation?. J Stud Alcohol. 1999, 60 (1): 54-63.CrossRefPubMed
Metadata
Title
Symptoms of common mental disorder and cognitive associations with seropositivity among a cohort of people coming for testing for HIV/AIDS in Goa, India: a cross-sectional survey
Authors
Rosie Mayston
Vikram Patel
Melanie Abas
Priya Korgaonkar
Ramesh Paranjape
Savio Rodrigues
Martin Prince
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-204

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue

Research article

Disparities in child mortality trends in two new states of India

Research article

A cross-sectional examination of school characteristics associated with overweight and obesity among grade 1 to 4 students

Research article

Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease

Research article

Impact of HbA1c criterion on the definition of glycemic component of the metabolic syndrome: the China health and nutrition survey 2009

Research article

Perspectives of pupils, parents, and teachers on mental health problems among Vietnamese secondary school pupils

Research article

Mental health status among Burmese adolescent students living in boarding houses in Thailand: a cross-sectional study