Infect Chemother.  2013 Jun;45(2):211-216. 10.3947/ic.2013.45.2.211.

Depression Among HIV-infected Patients in Korea: Assessment of Clinical Significance and Risk Factors

• Song JY
• Lee JS
• Seo YB
• Kim IS
• Noh JY
• Baek JH
• Cheong HJ
• Kim WJ

• KMID: 2285002
• DOI: http://doi.org/10.3947/ic.2013.45.2.211

Abstract

BACKGROUND
With prolonged life expectancies, mental illness has emerged as a disabling disorder among people with HIV.
MATERIALS AND METHODS
This study was conducted to assess the prevalence of depression and its risk factors among Korean patients with HIV infections. Eighty-two HIV-infected patients completed structured questionnaires including the Beck Depression Inventory and the State-Trait Anxiety Inventory. Subjects with depression were compared to those without depression in terms of demographics, comorbidities, CD4 T-cell count, RNA copy numbers, highly active antiretroviral therapy (HAART) regimens, and adherence.
RESULTS
The estimated depression rate was 21% (17 of 82 subjects). Comorbidities (47% vs. 20%, P = 0.01) and unemployment (65% vs. 31%, P = 0.02) were risk factors for depression. Depressive patients were more likely to be anxious (71% vs. 29%, P < 0.01), to frequently miss clinical appointments each year (P = 0.04), and to have higher cumulative time lost to follow-up per month (P <0.01) compared to non-depressive patients. Only three depressive patients were referred to neuropsychologists.
CONCLUSIONS
More than 20% of the Korean HIV patients in this study suffered from depression associated with poor adherence. Considering the low level of recognition of depression by clinicians, risk factor-based active assessment is recommended to manage depression properly in HIV-infected patients.

Keyword

HIV; Acquired immunodeficiency syndrome; Depression; Anxiety

MeSH Terms

Acquired Immunodeficiency Syndrome
Antiretroviral Therapy, Highly Active
Anxiety
Appointments and Schedules
Coat Protein Complex I
Comorbidity
Demography
Depression
HIV
HIV Infections
Humans
Life Expectancy
Lost to Follow-Up
Prevalence
Risk Factors
RNA
T-Lymphocytes
Unemployment
Surveys and Questionnaires
Coat Protein Complex I
RNA

Reference

1. Berger-Greenstein JA, Cuevas CA, Brady SM, Trezza G, Richardson MA, Keane TM. Major depression in patients with HIV/AIDS and substance abuse. AIDS Patient Care STDS. 2007. 21:942–955.

2. Kaharuza FM, Bunnell R, Moss S, Purcell DW, Bikaako-Kajura W, Wamai N, Downing R, Solberg P, Coutinho A, Mermin J. Depression and CD4 cell count among persons with HIV infection in Uganda. AIDS Behav. 2006. 10:4 Suppl. S105–S111.

3. Kelly B, Raphael B, Judd F, Perdices M, Kernutt G, Burrows GD, Burnett PC, Dunne M. Psychiatric disorder in HIV infection. Aust N Z J Psychiatry. 1998. 32:441–453.

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.

5. García de Olalla P, Knobel H, Carmona A, Guelar A, López-Colomés JL, Caylà JA. Impact of adherence and highly active antiretroviral therapy on survival in HIV-infected patients. J Acquir Immune Defic Syndr. 2002. 30:105–110.

6. Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011. 58:181–187.

7. Bangsberg DR. Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006. 43:939–941.

8. Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, Bamberger JD, Chesney MA, Moss A. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000. 14:357–366.

9. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000. 160:2101–2107.

10. Osborn CY, Egede LE. The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: the role of social support. Gen Hosp Psychiatry. 2012. 34:249–253.

11. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961. 4:561–571.

12. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of beck depression inventory in Korea. J Korean Neuropsychiatric Assoc. 1986. 25:487–502.

13. Hahn DW, Lee CH, Chon KK. Korean adaptation of Spielberger's STAI (K-STAI). Korean J Health Psychol. 1996. 1:1–14.

14. Valente SM. Depression and HIV disease. J Assoc Nurses AIDS Care. 2003. 14:41–51.

15. Park JH, Kim KW. A review of the epidemiology of depression in Korea. J Korean Med Assoc. 2011. 54:362–369.

16. Adewuya AO, Afolabi MO, Ola BA, Ogundele OA, Ajibare AO, Oladipo BF, Fakande I. Relationship between depression and quality of life in persons with HIV infection in Nigeria. Int J Psychiatry Med. 2008. 38:43–51.

17. Judd F, Komiti A, Chua P, Mijch A, Hoy J, Grech P, Street A, Lloyd J, Williams B. Nature of depression in patients with HIV/AIDS. Aust N Z J Psychiatry. 2005. 39:826–832.

18. Olley BO, Seedat S, Nei DG, Stein DJ. Predictors of major depression in recently diagnosed patients with HIV/AIDS in South Africa. AIDS Patient Care STDS. 2004. 18:481–487.

19. Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001. 158:725–730.