Prevalence and Socio-demographic Determinants of Depression among Patients Attending HIV/AIDS Clinic in a Teaching Hospital in Imo State, Nigeria

Chinyere M. Aguocha^1, , Richard U. Uwakwe², Chukwuma B. Duru³, Kelvin C. Diwe³, Justine K. Aguocha⁴, Okezie O. Enwere¹ and Emmanuel O. Olose⁵

¹Department of Internal Medicine, Imo State University, Owerri, Imo State, Nigeria

²Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State Nigeria

³Department of Community Medicine, Imo State University, Owerri, Imo State, Nigeria

⁴Department of Surgery, Imo State University, Owerri, Imo State, Nigeria

⁵Department of Psychiatry, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria

Cite this paper:
Chinyere M. Aguocha, Richard U. Uwakwe, Chukwuma B. Duru, Kelvin C. Diwe, Justine K. Aguocha, Okezie O. Enwere and Emmanuel O. Olose. Prevalence and Socio-demographic Determinants of Depression among Patients Attending HIV/AIDS Clinic in a Teaching Hospital in Imo State, Nigeria. American Journal of Medical Sciences and Medicine. 2015; 3(6):106-112. doi: 10.12691/ajmsm-3-6-4

Abstract

Background: Depression is one of the most common psychiatric complications associated with HIV disease. In Nigeria depression has been found to be five times more common among People Living with HIV AIDS (PLWHA) than in apparently healthy populations. Aim: To assess the prevalence, socio-demographic determinants and phenomenology of depressive disorder among HIV patients attending HIV clinic in Imo State University Teaching Hospital Orlu, Imo State, Nigeria. Methodology: This we did through a cross-sectional descriptive survey, carried out on 271 patients aged 18years and above receiving Highly Active Antiretroviral Treatment (HAART). We used Patient Health Questionnaire 9 to assess depressive disorder. The associations between depressive disorder and socio-demographic profiles among the genders were explored. Results: About 39.1% of the participants were found to be depressed, out of which 24.5% were mildly depressed, 50% moderately depressed and 24.5% severely depressed. More female participants, (28.0%) were found to be depressed than their male counterparts, (11.1%) although this difference was not statistically significant, (χ²=0.21, p=0.65). The rate (χ²=4.14, p=0.04) and severity (χ²=8.64, p=0.04) of concentration impairment was significantly higher in females compared to males. Conclusion: We concluded that the relatively high prevalence of depressive disorder among attendees at the HIV/AIDS clinic underscores the need for routine depression screening in these patients.

Keywords:
prevalence socio-demographic determinants depressive disorder HIV/AIDS clinic Nigeria

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References:

[1]	UNAIDS. Global Report: Annexes'. UNAIDS Report on the global AIDS epidemic. http://aidsinfo.unaids.org, accessed on July 18, 2015.
[2]	Marcus M, Yasamy T, Ommeren M, Chisholm D, Shekhar S. Depression A Global Public Health Concern. WHO Department of Mental Health and Substance Abuse. 2012.
[3]	Gureje O, Uwakwe R, Oladeji B, Makanjuola VO, Esan O. Depression in adult Nigerians: results from the Nigerian Survey of Mental Health and Well-being. J Affect Disord 2010; 120(1-3): 158-64.
[4]	Valente SM. Depression and HIV disease. Journal of the Association of Nurses in AIDS Care 2003; 14(2): 41-51.
[5]	Chikezie UE, Otakpor AN, Kuteyi OB, James BO. Depression among people living with human immunodeficiency virus infection/acquired immunodeficiency syndrome in Benin City, Nigeria: A comparative study. Niger J Clin Pract 2013; 16: 238-42.
[6]	Gaynes BN, Pence BW, Atashil 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).
[7]	Brandt R. The mental health of people living with HIV/AIDS in Africa: A systematic review. African Journal of AIDS Research 2009; 8(2): 123-133.
[8]	Iwudibia OO, Brown A. HIV and depression in Eastern Nigeria: The role of HIV-related stigma. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV 2014; 26: 5.
[9]	Shittu RO, Issa BA, Olanrewaju GT, Mahmoud AO, Odeigah LO, Salami AK, Aderibigbe SA. Prevalence and Correlates of Depressive Disorders among People Living with HIV/AIDS, in North Central Nigeria. J AIDS Clin Res 2013; 4:11.
[10]	Nyirenda M, Chatterji S, Rochat T, Mutevedzi P, Newella M. Prevalence and correlates of depression among HIV-infected and -affected older people in rural South Africa. J Affect Disord 2013; 151(1): 31-38.
[11]	Olley BO. Psychological distress in the first year after diagnosis of HIV infection among women in South Africa AJAR. 2006; 5(3): 207-215.
[12]	Bayon C., Robertson K., Wolf E., et al. The prevalence of a positive screen for anxiety and/or depression in HIV-1 infected women across Western Europe and Canada: the CRANIum study. 2nd International Workshop on HIV & Women. January 9-10, 2012, Bethesda, Maryland. Abstract O_01, 11.
[13]	Monahan PO., Shacham E, Reece M, Kroenke K., Ong'or WO, Omollo O, Yebei VN, Ojwang C. Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. J Gen Intern Med. 2009;24(2):189-97.
[14]	Li L, Liang L, Lee S, Farmer S. HIV Status and Gender: A Brief Report from Heterosexual Couples in Thailand. Women Health. 2012; 52(5): 472-484.
[15]	Aljassem K, Raboud JM, Hart TA, Benoit A, Su D, Margolese SL, Rourke SB, Rueda S, Burchell A, Cairney J, Shuper P, Loutfy MR and The OHTN Cohort Study Research Team. Gender Differences in Severity and Correlates of Depression Symptoms in People Living with HIV in Ontario, Canada. J Int Assoc Provid AIDS Care 2014.
[16]	Bonolo P, Ceccato M, Rocha G, Acúrcio F, Campos L, Guimarães M. Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy. Clinics (Sao Paulo) 2013; 68(5): 612-620.
[17]	Shanthi G, Damodharan J, and Priya G. Depression And Coping: A Study On HIV Positive Men And Women. A Sri Ramachandra Journal of Medicine 2007; 15-19.
[18]	Ciesla JA, Roberts JE. Meta-analysis of relationship between HIV infection and risk for depressive disorders. Am J Psychiatry 2001; 158: 725-30.
[19]	Kroenke K, Spitzer RL. The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatric Annals 2002; 32:9.
[20]	Adewuya AO, Ola BA, Afolabi OO. Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. Journal of Affective Disorders 2006; 96(1-2): 89-93.
[21]	Mao L, Kippax SC, Newman CE et al. Rates of depression among men attending high-HIV-caseload general practices in Australia. Mental Health and Family Medicine 2008; 5(2):79-83.
[22]	Tung MY, Gee ML, Guan NC et al. Identifying depression among the Human Immunodeficiency Virus (HIV) patients in University Malaya Medical Centre, Kuala Lumpur, Malaysia. ASEAN Journal of Psychiatry 2009; 10: 1-13.
[23]	Ownby RL, Jacobs RJ, Waldrop-Valverde D et al. Depression care and prevalence in HIV-positive individuals. Neurobehavioral HIV Medicine 2010; 2 :73-83.
[24]	Su X, Lau JT, Mak W, et al. Prevalence and associated factors of depression among people living with HIV in two cities in China. Journal of Affective Disorders 2013; 149: (1-3)108-115.
[25]	Gonzalez J, Hendriksen E, Collins E, Duran R, Safren S. Latinos and HIV/AIDS: Examining Factors Related to Disparity and Identifying Opportunities for Psychosocial Intervention Research. AIDS and Behavior. 2009;13:582-602.
[26]	Do AN, Rosenberg ES, Sullivan ES et al. Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System 2014; Plos one 9 (3) e9284.
[27]	Kinyanda E, Hoskins S, Nakku J, et al. Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda. BMC Psychiatry 2011; 11: 205.
[28]	Agaba PA, Meloni ST, Sule HM et al. Patients who present late to HIV care and associated risk factors in Nigeria. British HIV Association. 2014.
[29]	Smith JD. Promiscuous Girls, Good Wives, and Cheating Husbands: Gender Inequality, Transitions to Marriage, and Infidelity in Southeastern Nigeria. Medical Anthropology Quarterly. 2010; 83(1).
[30]	Federal Government of Nigeria. National Policy on HIV/AIDS. Nigeria 2009;unfpa.org/pdf/ntpol.pdf. Accessed on 15th May 2015
[31]	Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexual Transmitted Diseases and Tuberculosis Prevention, Centers for Disease Control and Prevention. . HIV Among Youth. 2015; www.cdc.gov/nchhstp. Accessed May 8, 2015.
[32]	World Health Organisation. ‘HIV-infected women and their families: psychosocial support and related issues: a literature review’. Department of Reproductive Health and Research. 2003; WHO/RHR/03.07.
[33]	Chippindale S, French L. ‘ABC of AIDS: HIV counselling and the psychosocial management of patients with HIV or AIDS’. British Medical Journal. 2001; 322 (7301).
[34]	Ryan C, Huebner D, Diaz RM and Jorge Sanchez. Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics. 2009; 123: (1) 346 -352.
[35]	Silverstein BP. Gender difference in the prevalence of clinical depression: the role played by depression associated with somatic symptoms. Am J Psychiatry. 1999; 156: 480-482.
[36]	Frank E, Carpenter LL, Kupfer DJ. Sex differences in recurrent depression: are there any that are significant? American Journal of Psychiatry. 1988; 145: 41-45.
[37]	Maffeo PA, Ford TW, Lavin PF. Gender differences in depression in an employment setting. J Pers Assess. 1990; 55(1-2):249-62.