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Child and Adolescent Psychiatry and Mental Health

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01-12-2020 | Affective Disorder | Research article

Depression and suicidality among adolescents living with human immunodeficiency virus in Lagos, Nigeria

Authors: Suraju Adeyemo, Increase I. Adeosun, Oluwayemi Cecilia Ogun, Abiodun Adewuya, Agatha Nkiru David, Abosede Adekeji Adegbohun, Olurotimi Adejumo, Oyewale Alfred Ogunlowo, Oluwatosin Oluwaseun Adeyemo

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2020

Abstract

Background

Nigeria is considered to have the second highest number of people living with human immunodeficiency virus (HIV) worldwide with a national HIV infection prevalence of 5.2% in children and adolescents. Adolescents with HIV-infection have been reported to be more prone to developing comorbid emotional difficulties including depression and suicidality compared to those without HIV-infection. This study is aimed at determining the prevalence and correlates of depression and suicidality in adolescents living with HIV infection.

Methods

Through a consecutive sampling method, two hundred and one adolescents attending HIV outpatient clinics in two tertiary hospital (Lagos state University Teaching Hospital and Nigerian Institute of Medical Research) were recruited. Confidentiality was assured and maintained. Suicidality and Depression were assessed with their corresponding modules in Mini International Neuropsychiatric Interview for children and adolescents (MINI-Kid) by researcher, while the independent variables were assessed using self-administered questionnaires. Data was analyzed with Statistical Package for Social Science version 20.

Result

The prevalence of current and lifetime major depressive episode, and suicidality were 16.9%, 44.8% and 35.3% respectively. Female gender, decreased cluster of differentiation 4 (CD4) count and high adverse childhood experience (ACE), were significantly associated with current depressive episode, while poor social support, high ACE, physical abuse, contacting HIV infection after birth and disclosure of status, were associated with lifetime major depressive episode. Factors associated with suicidality were high ACE score, physical abuse, and emotional abuse. After logistic regression analysis; gender, high ACE and CD4 level were independently associated with current major depression, while only poor social support and contracting HIV infection after birth, were independently associated with lifetime major depression. There was a positive correlation between suicidality and depression.

Conclusion

The presence of high rate of depression and suicidality among adolescents living with HIV-infection in the current study clearly shows the need for regular psychological assessment in these group of adolescents, and thus a strong indication for a multidisciplinary management in them.

Rm N, Okerentugba P. Pattern of HIV prevalence in tertiary hospitals in Rivers State. Int J Novel Res Healthcare Nursing. 2017;4(2):7–12.

The Joint United Nations Programme on HIV and AIDS. Global aids update; 2016. http://www.who.int/hiv/pub/arv/global-AIDS-update-2016_en.pdf. Accessed 3 June 2018.

Close KL. Psychosocial aspects of HIV/AIDS : children and adolescents. HIV curriculum for the Health Professional. 2006. http://bipai.org/sites/bipai/files/24-Psychosocial-Children.pdf. Accessed 3 June 2018.

Judd F, Komiti A, Chua P. Nature of depression in patients with HIV/AIDS. Aust N Z J Psychiatry. 2005;39(9):826–32. https://doi.org/10.1111/j.1440-1614.2005.01659.x.CrossRefPubMed

Vranda MN, Mothi SN. Psychosocial issues of children infected with HIV/AIDS. Indian J Psychol Med. 2013;35(1):19–22. https://doi.org/10.4103/0253-7176.112195.CrossRefPubMedPubMedCentral

Adewuya AO, Ola BA, Aloba OO. Prevalence of major depressive disorders and a validation of the Beck Depression Inventory among Nigerian adolescents. Eur Child Adolesc Psychiatry. 2007;16(5):287–92. https://doi.org/10.1007/s00787-006-0557-0.CrossRefPubMed

Maria HK, Alick CM, Xiaoying YU, Akash D, Chi N, Saeed A, Peter NK, Carla S. Factors associated with depression among adolescents living with HIV in Malawi. BMC Psychiatry. 2015;15(264):1–12. https://doi.org/10.1186/s12888-015-0649-9.CrossRef

Musisi S, Kinyanda E. Emotional and behavioural disorders in HIV seropositive adolescents in urban Uganda. East Afr Med J. 2009;86(1):16–24.CrossRef

Shittu RO, Issa BA, Olanrewaju GT, Mahmoud AO, Odeigah LO SA and AS. Prevalence and Correlates of Depressive Disorders among People Living with HIV/AIDS, in North Central Nigeria. J AIDS Clin Res. 2013;04(11):251. https://doi.org/10.4172/2155-6113.1000251.

10.

Carrico AW, Johnson MO, Morin SF. Correlates of suicidal ideation among HIV-positive persons. AIDS. 2007;21(9):1199–203. https://doi.org/10.1097/QAD.0b013e3281532c96.CrossRefPubMed

11.

Kaharuza FM, Bunnell R, Moss S, Purcell DW, Bikaako- Kafura W, Wamai N, Downing R, Solberg P, Coutinho AMJ. Depression and CD4 cell count among person with HIV infection in Uganda. AIDS Behav. 2006;10:S105–11.CrossRef

12.

Giri S, Neupane M, Pant S, et al. Quality of life among people living with acquired immune deficiency syndrome receiving anti-retroviral therapy: a study from Nepal. HIV AIDS (Auckl). 2013;5:277–82.PubMedPubMedCentral

13.

Rabkin JG, Williams JB, Remien RH, Goetz R, Kertzner RGJ. Depression, distress, lymphocyte subsets, and human immunode- ficiency virus symptoms on two occasions in H48IV-positive homosexual men. Arch Gen Psychiatry. 1991;48:111–9.CrossRef

14.

Govender RD, Schlebusch L. Hopelessness, depression and suicidal ideation in HIV-positive persons. South African J Psychiatry. 2012;18(1):16–21.CrossRef

15.

Kinyanda E, Hoskins S, Nakku J, Nawaz S, Patel V. The prevalence and characteristics of suicidality in HIV/AIDS as seen in an African population in Entebbe district, Uganda. BMC Psychiatry. 2012;12(1):63. https://doi.org/10.1186/1471-244X-12-63.CrossRefPubMedPubMedCentral

16.

Abiola T, Udofia O, Zakari M. Psychometric properties of the 3-item oslo social support scale among clinical students of Bayero University Kano. MJP online: Nigeria; 2013.

17.

Oladeji BD, Makanjuola VA, Gureje O. Family-related adverse childhood experiences as risk factors for psychiatric disorders in Nigeria. Br J Psychiatry. 2010;196(3):186–91.CrossRef

18.

Kazeem OT. A Validation of the Adverse Childhood Experiences Scale in. Res Humanit Soc Sci. 2015;5(11):18–24.

19.

Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(2):22–33 (quiz 34–57).PubMed

20.

Kurapati S, Vajpayee M, Raina M, Vishnubhatla S. Adolescents Living with HIV: an Indian profile. AIDS Res Treat. 2012;2012:1–7. https://doi.org/10.1155/2012/576149.CrossRef

21.

Shehu Sale MG. Prevalence and factors associated with depression in HIV/AIDS patients aged 15–25 years at Aminu Kano Teaching Hospital, Nigeria. J Child Adolesc Ment Health. 2008;20(2):95–9.CrossRef

22.

Gaynes BN, Pence BW, Atashili J, O’Donnell J, Kats D, Ndumbe PM. Prevalence and predictors of major depression in HIV-infected patients on antiretroviral therapy in Bamenda, a semi-urban center in Cameroon. PLoS ONE. 2012;7(7):e41699. https://doi.org/10.1371/journal.pone.0041699.CrossRefPubMedPubMedCentral

23.

Mazenga AC. Determining the prevalence of depression among HIV infected Adolescents receiving care at Baylor children’s clinical center of excellence LIlongwe Malawi. Malawi: Baylor Children’s Foundation Clinical Centre of Excellence Malawi (BCM COE); 2010.

24.

Chikezie UE, Otakpor AN, Kuteyi OBJB. Suicidality among individuals with HIV/AIDS in Benin City, Nigeria: a case-control study. AIDS Care. 2012;7(24):843–5. https://doi.org/10.1080/09540121.2011.CrossRef

25.

Adeniyi AF, Okafor NC, Adeniyi CY. Depression and physical activity in a sample of nigerian adolescents: levels, relationships and predictors. Child Adolesc Psychiatry Ment Health. 2011;5(1):16. https://doi.org/10.1186/1753-2000-5-16.CrossRefPubMedPubMedCentral

26.

Hoeksema N. Gender differences in depression. Curr Dir Psychol Sci. 2001;10(5):173–6. https://doi.org/10.3109/09540261.2010.492391.CrossRef

27.

Raymond LO, Robi JJ, Drenna WFG. Depression care and prevalence in HIV-positive individuals. Neurobehav HIV Med. 2010;2:73–83. https://doi.org/10.2147/NBHIV.S7296.CrossRef

28.

Mellins CA, Malee KM. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc. 2013;16(1):18593. https://doi.org/10.7448/ias.16.1.18593.CrossRefPubMedPubMedCentral

29.

Murphy DA, Moscicki AB, Vermund SH, Muenz LR. Psychological distress among HIV(+) adolescents in the REACH study: effects of life stress, social support, and coping. The Adolescent Medicine HIV/AIDS Research Network. J Adolesc Heal. 2000;27(6):391–8.CrossRef

30.

Straus MA. Measuring intrafamily conflict and violence: the Conflict Tactics (CT) Scales. In: Straus MA, Gelles RJ, editors. Physical violence in American families: risk factors and adaptations to violence in 8,145 families. New Brunswick: Transaction Publishers; 1990.

31.

National Population Commission (NPC) [Nigeria] and ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, 2014. https://dhsprogram.com/pubs/pdf/fr293/fr293.pdf. Accessed 3 July 2018.

32.

Jewkes RK, Dunkle K, Nduna M, Jama PN, Puren A. Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth. Child Abus Negl. 2010;34(11):833–41. https://doi.org/10.1016/j.chiabu.2010.05.002.associations.CrossRef

33.

Préau M, Bouhnik AD, Peretti-Watel P, Obadia Y, Spire B. Suicide attempts among people living with HIV in France. AIDS Care. 2008;20(8):917–24. https://doi.org/10.1080/026520306011.CrossRefPubMed

34.

Lee MBR-BM. Parent’s disclosure of HIV to their children, AIDS. AIDS. 2002;16:2201–7.CrossRef

35.

Mellins CA, Brackis-Cott E, Dolezal C, Richards A, Nichoas SAE. Patterns of HIV disclosure to perinatally HIV-infected children and subsequent mental health outcomes. Clin Child Psychol Psychiatry. 2002;7:101–14.CrossRef

36.

Lee SJ, Detels R, Rotheram-Borus MJ, Duan N, Lord L. Depression and social support among HIV-affected adolescents. AIDS Patient Care STDs. 2007;21(6):409–17. https://doi.org/10.1089/apc.2006.0066.Depression.CrossRefPubMedPubMedCentral

37.

Amanor-Boadu S, Hipolito MS, Rai N, et al. Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans. World J Psychiatry. 2016;6(1):128–35. https://doi.org/10.5498/wjp.v6.i1.128.CrossRefPubMedPubMedCentral

38.

Omigbodun O, Dogra N, Esan O, Adedokun B. Prevalence and correlates of suicidal behaviour among adolescents in Southwest Nigeria. Int J Soc Psychiatry. 2008;54(1):34–46. https://doi.org/10.1177/10020764007078360.CrossRefPubMed

39.

Fergusson DM, Woodward LJ, Horwood LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med. 2000;30:23–39.CrossRef

40.

Mota N, Elias B, Tefft B, Medved M, Munro G, Sareen J. Correlates of suicidality: investigation of a representative sample of manitoba first nations adolescents. Am J Public Health. 2012;102(7):1353–61. https://doi.org/10.2105/AJPH.2011.300385.CrossRefPubMedPubMedCentral

41.

Slonim-Nevo VML. Child abuse and AIDS-related knowledge, attitudes and behavior among adolescents in Zambia. Child Abuse Negl. 2007;31(2):143–9.CrossRef

42.

National clearinghouse on child abuse and neglect information. Child abuse and neglect prevention. 2006. http://nccanch.acf.hhs.gov.

43.

Kelly B, Raphael B, Judd F, et al. Suicidal ideation, suicide attempts, and HIV infection. Psychosomatics. 1998;39(5):405–15.CrossRef

44.

Khartri K. Child abuse, definition, prevention, types, treatment, maltreatments articles, children’s abuse; 2004. http://www.umicos.umd.edu/users/sawweb/sawnet/childabuse.html. Access 3 July 2018.

45.

Ogundipe OA, Olagunju AT. Adeyemi JD Suicidal ideation among attendees of a West African HIV clinic. Arch Suicide Res. 2015;19(1):103–16.CrossRef

46.

Preau M, Anne DB, Patrick PW, Yolanda O, Spire B. Suicide attempts among people living with HIV in France. AIDS Care Taylor Fr. 2008;20(08):917–24.CrossRef

Title: Depression and suicidality among adolescents living with human immunodeficiency virus in Lagos, Nigeria
Authors: Suraju Adeyemo
Increase I. Adeosun
Oluwayemi Cecilia Ogun
Abiodun Adewuya
Agatha Nkiru David
Abosede Adekeji Adegbohun
Olurotimi Adejumo
Oyewale Alfred Ogunlowo
Oluwatosin Oluwaseun Adeyemo
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Affective Disorder
Human Immunodeficiency Virus
Affective Disorder
Published in: Child and Adolescent Psychiatry and Mental Health / Issue 1/2020
Electronic ISSN: 1753-2000
DOI: https://doi.org/10.1186/s13034-020-00337-3

At a glance: The STEP trials

Springer Medicine

Depression and suicidality among adolescents living with human immunodeficiency virus in Lagos, Nigeria

Abstract

Background

Methods

Result

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

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