Multivariable logistic regression was used to determine factors associated with depression. Out of this, The clinician should early recognize and treat drug side effects, early detect and manage opportunistic infection and other chronic diseases, and give health information about the disease for the community to reduce social stigma. Depression is a common mental disorder presents with depressed mood, loss of interest, feelings of guilt, disturbed sleep, and poor concentration [ 1 ]. It is the leading cause of disability and the fourth leading contributor to the global burden of disease [ 2 , 3 ].
Many studies were also set up in such populous nations as China and India. Among people without a history of psychiatric disorders or depression in the Swiss HIV Cohort Study, depression developed at a rate of 3. But the most recent studies, in Switzerland 8 and the United States, 22 ran up to the most recent antiretroviral era from to depresaion focused on all-cause mortality. Health Med. Survey procedure Depresson contacted the headmasters of local schools with the help of the Center for Disease Control and the Prevention officer. Study depressin were allocated to their Valentines hentai study setting through a proportional allocation method. This Hiv depression research is similar with studies done in Malawi [ 11 ], Addis Ababa [ 16 Hiv depression research, Hawassa [ 13 ] and China [ 12 ].
Reasons to learn latin. Depression Rate 2 to 3 Times Higher With HIV
Hiv depression research, findings here were generally consistent with depresssion has been reported in other sub-Saharan Africa sites. Arch Gen Psychiatry 8— Collagen is an essential building block for the entire rsearch, from skin to gut, and more. It showed that people with HIV run twice the risk of depression as those who are at-risk for HIV but remain uninfected. With a chronic condition like HIV, depression can fuel additional problems, such as failure to take life-saving antiretroviral medications. Older patients sometimes become bitter seeing young people frolicking carelessly. This may lead to changes in how a person thinks and behaves. They have also been sick for many years and may have been unable to save enough money for retirement. Two variables stood out as significant predictors of MDD within the past year. Poor mental Hiv depression research is not the same as mental illness. Mental health affects how True sex video think, feel, and act. ET Send us an email.
- From women who need to address past trauma to young people addicted to street drugs, all people with HIV need support to fight depression.
- The destruction of these cells leaves people infected with HIV vulnerable to other infections, diseases and other complications.
- Recent blue-ribbon panel reports have concluded that HIV treatment programs in less wealthy countries must integrate mental health identification and treatment into normal HIV clinical care and that research on mental health and HIV in these settings should be a high priority.
- When you test positive for HIV, your whole world can change in an instant.
- Good mental health helps people make healthy choices, reach personal goals, develop healthy relationships, and cope with stress.
Metrics details. Perceived social support, planning and positive reappraisal were negatively related to the depression. Conversely, social desirability, catastrophizing and other-blame were positively associated with the depression.
Psychosocial factors have an important influence on the depression experienced by HIV-infected children. Interventions from personal subjective psychosocial to reduce depression in HIV-infected children in China are warranted. Human immunodeficiency virus HIV infection has become a significant social emergency worldwide. HIV is threatening children as never before. Although the epidemic trend of global HIV infection was declining, children represent a growing share of people living with HIV worldwide and China is no exception [ 2 ].
Children infected by HIV not only suffer from the heavy burden of physical disease associated with chronic illness but are also at risk of developing mental health disorders.
Depression is the most common neuropsychiatric complication in HIV-infected children and may occur during all phases of the infection [ 3 ]. Depression in HIV-infected children leads to a negative impact on a wide range of aspects of their life quality and has a profoundly deleterious influence on society [ 4 , 5 , 6 ].
Previous studies have shown that HIV-infected children suffering from depression are more likely to develop maladaptive outcomes and behaviors, including dropping out of school, drug abuse, alcohol use, and engaging in high-risk sexual behaviors that increases the risk of HIV transmission [ 7 , 8 ]. Depression also has a wide range of negative effects on the progression of illness in HIV-infected children.
It decreases their immune status and adherence to antiretroviral therapy, which may result in the potential development of drug resistance and decreased clinical effectiveness [ 9 , 10 ], increasing the disease cost burden and mortality associated with illness [ 11 , 12 , 13 ].
Therefore, it is imperative to explore the factors influencing the development of depression in HIV-infected children.
Childhood is full of challenges that children have to deal with, including pressures coming from academic study, the relationships with peers, changes in the body and from the development of cognition function. Children who are early in psychological developmental stages, including cognition, are more sensitive to stressful events and more susceptible to the impact of social desirability [ 14 , 15 ].
HIV-infected children may suffer from more stressors caused by a higher exposure to traumatic life events which result in depression, in addition to those events experienced by healthy children.
Despite the prevalence of HIV being low in China, levels of stigma remain widespread and profound [ 16 , 17 ]. HIV-infected children are confronted with stereotypes, discrediting, prejudice, and discrimination caused by HIV infection-related stigma that may lead to them being isolated, helpless, and bullied [ 18 , 19 ].
HIV-infected children face negative impacts in many ways within society. In terms of coping with stigma and integrating into society, HIV-infected children may also be affected by social desirability. Social desirability can be viewed as a tendency to present oneself favorably or to obtain approval by responding in a culturally and socially acceptable manner [ 20 ].
Studies have shown that social desirability correlates with depression in normal children but findings are heterogeneous [ 21 , 22 ]. No known studies to date have explored the effects of social desirability on responses to depression in HIV-infected children. In addition to the pressure of stigma, HIV-infected children may suffer as a result of illness experienced by their parents, poor relationships with their parents, and even the loss of their parents.
The persistent use medication over a long time and uncertain trajectory of their illness likely make children susceptible to depression. Perception of social support is a subjective aspect of social support, referring to the emotional experience and satisfaction of being respected, supported, and understood. Indeed, the perception of social support can have a directly beneficial impact on mental health [ 23 , 24 ] and buffer against suicide risk created by stressful life events [ 25 ].
Cognitive emotion regulation is also an important factor. Studies have illustrated that emotion regulation plays a significant role in the mental health of children [ 26 , 27 ]. Cognitive emotion regulation refers to the cognitive means of handling the intake of emotionally arousing stimulations [ 28 ]. Studies have shown that using different cognitive emotion regulation strategies has different outcomes [ 29 , 30 ].
The strongest relationships have been found between the cognitive emotion regulation strategies of rumination, catastrophizing, and self-blame and the reporting of symptoms of depression [ 31 , 32 , 33 , 34 ]. These findings might imply that by using these strategies, children may be more vulnerable to developing symptoms of depression in response to negative life events than others [ 34 ]. Despite the increased interest in this field and the publication of studies highlighting the high levels of depression in children, there continues to be a dearth of data concentrating on the personal subjective psychosocial perspective.
Research is needed to examine the associated influencing factors of depression in HIV-infected children, especially in the Chinese socio-cultural context. Previous studies exploring depression in HIV-infected children are mostly from the perspectives of society and family. It was hoped that this would provide a basis for developing measures to reduce the levels of depression and effectively improve life conditions for HIV-infected children.
The current study was conducted in a county of the Henan Province, named Shangcai, an area with one of the highest incidences of HIV-infection in China. Here, a large number of rural residents were affected with HIV through unhygienic blood collection practices in the late s and early s. Although official prevalence data were not available for Shangcai county, local epidemiological surveys report that HIV infection rates were as high as 9.
We obtained village-level HIV surveillance data from the anti-epidemic station to screen the names of HIV-infected children.
Sample selection took place using randomized stratified cluster sampling from 43 of 71 schools in the district. We contacted the headmasters of local schools with the help of the Center for Disease Control and the Prevention officer.
The headmasters in each school called the HIV-infected children together. Once the time and place were confirmed, interviewers accompanied by the headmasters visited the child and provided them with a detailed description of the study design and potential benefits and risks including confidentiality issues. The resource persons included community leaders, caregivers, or school headmasters.
The children and their guardians were assured of confidentiality. For participants with limited literacy, it was necessary to provide clarification or instruction when needed. The interviewers were trained education and psychology graduate students. The questionnaires were collected immediately when completed. We checked the questionnaires to avoid errors and ensure data quality and provided a gift as a token of appreciation for participation.
Children were asked to report on individual and family characteristics. A three-factor model was proposed for the Chinese version of the CDI [ 36 ].
Items are scored from 0 to 2, with a higher score indicating a greater level of symptom severity. The CERQ includes nine conceptually distinct scales. These scales all consist of two items referring to what people think after the experience of threatening or stressful life events, ranging from 1 almost never to 5 almost always.
A subscale score can be obtained by adding up the two items, the minimum score is 0 and the maximum score is 8. The higher the subscale score, the more the specific cognitive strategy is used. The perceived social support measure was adapted from the Multidimensional Scale of Perceived Social Support MPSS scale [ 40 ], which has been validated in children and adolescents [ 41 , 42 ]. The original MPSS scale included three subscales assessing the source of emotional support family, friends, or significant others.
The version has 48 true—false items. Answers that matched the socially desirable choice were scored as 1 point. Possible scores ranged from 0 to 48 with higher scores indicating a higher tendency toward socially desirable responding.
The Statistical Package for Social Sciences Differences between the groups were tested by Chi square test. In addition, Pearson correlation analyses were conducted to examine the strength of associations between all variables. The nine subscales of measure of cognitive emotion regulation were regarded as nine variables. Thus, we assessed all variables thought to be potentially correlated with depression based on previous studies.
The initial bivariate correlations analysis identified six variables thought to be possibly associated with depression. And we used step-wise fashion in the linear regression. A total of 47 participants Of the participants, 83 The average age of the participants was The numbers of participants in each grade were as follows: primary school, 17; senior school, 87; junior school, 28; and others, Of the children, 70 had lost one or both parents and 75 still had both parents alive.
In the linear regression, the three variables planning, positive reappraisal and other-blame were excluded from the model. In the first model the perceived social support accounted for In the second model, the explaining variance increased to In the final model, the explaining variance increased to The findings of this study support psychosocial factors have an important influence on the depression in HIV-infected children.
Among the three influential factors, the strongest indicator of depression was perceived social support. Studies have found that lower perceived adequacy of social support has been linked to poor mental health [ 44 , 45 ].
Similarly, Bal et al. This in line with other studies showing that people with HIV who reported greater satisfaction with their social support had lower rates of depression [ 48 ] and greater perceived social support was associated with better mental health [ 49 ]. Social resources are generally protective against adverse psychological responses to stressful situations [ 50 ]. The perceived availability of social support may prevent or reduce the occurrence of depressive symptoms by preventing a potential stressor from being perceived as stressful.
HIV-infected children may experience a greater number of stressful situations caused by higher exposure to traumatic events. HIV-infected children with a higher level of social support may be more likely to believe that others would provide the necessary resources to solve the problem when they encounter stress. This may help them redefine the potential harm posed by their stressful situations and prevent or alter maladaptive behavioral responses to stressful events.
It is possible that HIV-infected children with low levels of perceived social support may experience heightened perceptions of threats of stressful events resulting in high levels of depressive symptoms. Enhancing perceived social support may, therefore, prevent or decrease depressive symptoms in HIV-infected children. We also observed a positive correlation between catastrophizing and depression, suggesting that by using the strategy of catastrophizing, HIV-infected children may be more vulnerable to developing and exacerbating depression in response to negative life events than others.
Studies have shown that cognitive emotion regulation styles such as self-blaming, catastrophizing, and rumination show strong relationships with internalizing problems [ 31 , 32 , 33 ]. Internalizing problems include difficulties that are directed inwards, such as disordered mood, anxiety, and depression [ 51 ]. A number of authors have suggested that depressive mood and symptoms could be a consequence of the frequent use of maladaptive emotion regulation [ 29 , 52 , 53 ].
In other words, although dysfunctional attitudes are accessible during stressful life periods, the strategies that individuals use to regulate these cognitions self-blaming, focus on positives, planning, positive reappraisal, catastrophizing seem to influence the occurrence of associated depression. In a study of HIV-infected men, Crues et al.
Gen Hosp Psychiatry 87— For those patients who endorsed suicidal ideation, most reported having passive thoughts without active thoughts of harming themselves Table 4. This impairment significantly limits your ability to function day-to-day at work, home, and during social activities. But staying nourished is important. These common crisis points include:. However, coping with the reality of living with a chronic illness can be challenging. Advocates for women with HIV have long said that helping them get past life traumas is essential for boosting health outcomes.
Hiv depression research. Depression
Depression in people living with HIV PLWH has become an urgent issue and has attracted the attention of both physicians and epidemiologists. This population is more likely to experience worsening disease states and, thus, poorer health outcomes. In this study, we analyzed research growth and current understandings of depression among HIV-infected individuals.
The number of papers and their impacts have been considerably grown in recent years, and a total of publications published from — were retrieved from the Web of Science database. Research landscapes related to this research field include risk behaviors and attributable causes of depression in HIV population, effects of depression on health outcomes of PLWH, and interventions and health services for these particular subjects. We identified a lack of empirical studies in countries where PLWH face a high risk of depression, and a modest level of interest in biomedical research.
By demonstrating these research patterns, highlighting the research gaps and putting forward implications, this study provides a basis for future studies and interventions in addressing the critical issue of HIV epidemics. By the end of , there were Depression is a mental health disorder that is highly prevalent, and characterized by low mood, diminished self-worth, pessimistic thoughts, poor concentration, and biological symptoms that of poor appetite and sleep difficulties and increased withdrawal from social activities.
Along with anxiety disorder, these psychiatric problems may result in chronic detrimental impairments and could even lead to suicidal ideation [ 3 ]. According to the recent World Health Organization WHO report, there have been over million people living with depression and nearly , patients died due to suicide each year [ 4 ]. Depressive disorders have caused over 50 million years lived with disability YLD worldwide, accounting for 7.
In individuals living with HIV, depression may worsen existing disease states and lead to poorer health outcomes. Prior research has revealed that depression is not only associated with higher HIV viral loads and lower CD4 cells count but also hastens the progression to AIDS and elevates the risk of mortality [ 6 , 7 ].
Furthermore, depression has been reported to reduce adherence to antiretroviral therapy ART , weaken its therapeutic effects, and compromises the medication outcomes at both individual and population scale [ 8 , 9 ]. As adherence to ART medications is instrumental in treatment effectiveness and clinical outcomes, ART interruption and discontinuation would worsen physical functioning, and along with depressive behaviors, this could result in further impairments in social relationships and a consequential reduced overall quality of life [ 11 ].
The comorbidity of HIV and depression typically results in longer onset depressive illnesses and more severe symptoms, such as higher distress and self-stigma, loss of appetite, and poorer sleep quality [ 12 ]. Additionally, the risk of experiencing moderate to severe depressive symptoms in patients that are non-adherent to ART was reported to be three-fold higher compared to adherent ones [ 13 ].
In recent years, there has been more research examining the effects of depression amongst individuals living with HIV. In , a study by Arseniou et al. Maria G. Nani and colleagues reviewed the epidemiological characteristics and achievements on diagnoses and treatments for people suffering from both HIV and depression [ 15 ].
Nonetheless, to the best of our knowledge, there is currently no study performed a thorough bibliometric analysis that quantitatively and qualitatively examines the extant literature of depression in HIV population.
In order to demonstrate the global research trends as well as identify the research gaps of depression among HIV-positive people, we applied bibliometric analysis, which objectively evaluates the productivity of global researchers or institutions in this field [ 17 ].
Additionally, this study also aimed at reporting the trend of published articles over time and measured international growth based on databases of published literature.
By pointing out the current trends. Document types rather than research articles and research reviews were excluded from the analysis. The language of the publications was restricted to English and only papers published before and in were chosen.
Data, including authors information name and affiliation , the title of papers, the name of journal, keywords, and abstracts, were sorted by total citations and downloaded from the Web of Science. Citation reports automatically created by the Web of Science were also downloaded. Standardization was performed by two analysts to merge the different name abbreviations of an author. Due to the vast records related to this topic, four researchers were involved and worked dependently in data filtering.
Two research teams worked independently to make sure that the results matched. One research team, based on the document types that had been shown by the Web of Science, the title, and keywords of the papers, excluded , papers.
The other team applied the same process to verify the results. Any conflict was solved by discussion. We analyzed data based on the total number of authors, year of publication, category, most popular keywords and their co-occurrence, citations, usages, and abstracts.
After downloading and extracting data, we applied Macro, a programming code run in the Excel environment to calculate a country citation, and intra- and inter-country collaboration. A network of countries sharing co-authorships, the author keyword co-occurrence network and countries network were created by VOSviewer version 1.
As for content analysis of the abstracts, we applied exploratory factor analysis to identify research domains emerging from all content of the abstract; loadings of 0. Not until the very first publication in did physicians start to pay more attention to depressive disorders in PLWH and significantly more papers were published, as illustrated by the considerable growth in the total number of papers over the research period. Especially in the last five years, total usage the number of times being downloaded and usage rates have increased highly.
The papers published in have been particularly sought after, evidently by the substantial total citations Table 1. Total usage: total downloads. The number of articles counted by study settings is presented in Table 2.
In total, there were cases in 60 countries. Many studies were also set up in such populous nations as China and India. Only a few study settings were located in such Asian developing countries as Vietnam, Taiwan, Thailand, etc. The United States of America appeared to be the knowledge hub of the world in this research topic, with the largest number of publications as well as densest co-authorships network, especially with its neighbor Canada and other large HIV populations, from South Africa, Uganda, to China, Thailand, and Cambodia.
The collaborating networks were also based on geographical locations. The green cluster, for instance, indicates collaboration of Western European countries, including France, Germany, Switzerland, Netherlands, and Belgium.
The global network among 68 countries having co-authorships of selected papers. The size of nodes shows the proportional contribution to the number of papers and the thickness of lines indicates the percentage of the number of collaborations. The principle components of keywords structure with the most frequent groups of terms are displayed in Figure 3. The clusters were emerged from most frequent key words co-occurrence of at least 20 times.
Nodes in red point out a number of HIV risk factors and behaviors violence, sexual abuse, substance use affecting vulnerable subjects, including women, adolescents, gay or bisexual men, transgender, and injection drug users, in highly infected populations, such as the United States and India.
Green nodes focus on symptoms of HIV infection and associated mental diseases major depression, schizophrenia, neurocognitive disorders , while the cluster in yellow characterizes major causes of these illnesses stigma, distress , as well as efforts and strategies to ameliorate these problems social and family support, community adjustment.
As for the content analysis of abstracts by exploratory factor analysis, the top 50 emerging research domains are listed in Table 3. The most common domain came to unprotected sex behaviors, accounting for more than half of total cases.
Depression in PLWH has also been explored through various aspects, including attributable causes social stigma and discrimination, violence, substance abuse , affected issues and associated consequences quality of life, medication adherence, suicidal ideation, and mortality , and possible interventions and coping strategies medical care, and social support.
Meanwhile, biomedical aspects, such as viral load and cell counts, and immune responses were not the choice of many researchers, as illustrated by the relatively low rank in the list 25 and 35, respectively. Demographic and epidemiological characteristics of PLWH suffering from depressive symptoms and anxiety were grouped in the red cluster. Risk behaviors sexual transmission, violence and the interventions and preventions in different time courses day, week s , and year were found to have strong correlation blue nodes.
Researchers also considered depressive responses in an immunological view purple nodes , whereas such topics as neuropsychological performance, cognitive functioning, tests for symptoms and severity of depression, and specific patient groups did not show any apparent co-occurrence pattern with other terms or topics.
Figure 4 presents the most frequent terms co-occurring with intervention s or trial s in the content analysis of all abstracts. Meanwhile, randomized controlled trial s , which were applied to measure medication adherence and quality of potential therapy, was apparently the most common type of study setting. The x-axis refers to the Jaccard coefficient that measures the similarity between finite sample sets and is defined as the size of the intersection divided by the size of the union of the sample sets.
This study revealed the development of research on depression in PLWH in terms of quantity and current interests. Along with the significant increase of scientific literature volume, depression among HIV-infected patients has been extensively examined. Research landscapes related to this field include risk behaviors and attributable causes of depression in HIV population, effects of depression on health outcomes of PLWH, and interventions and health services for these particular subjects.
Notable research gaps and future implications for further study on depression among PLWH are also discussed in this section. In terms of collaborating framework, in addition to the regional collaboration, which is due to the similarities in socioeconomic characteristics, this research field has also witnessed the cooperation between the United States and other South East Asian nations, namely Thailand and Cambodia Figure 2.
By , the Thai-U. With the help of the U. Risky sex behaviors, including unprotected sexual activities and anal sex, have been the most researched topic in the top 50 research domains Table 3. Nevertheless, there were limited studies set up in Thailand—the home to populations exhibiting those risk behaviors most frequently, such as sex workers, transgender people, and homosexual men or men who have sex with men MSM , to name a few Table 2.
Since female sex workers are usually exposed to a high risk of sexually transmitted diseases, work-related violence, and unwanted pregnancy, and experience both perceived and self-stigma due to their work characteristics, the prevalence of major depression of this group has been reported to be higher compared to general population [ 26 , 27 , 28 , 29 ]. Transgender people and MSM are also vulnerable to anxiety and depression, as they have to experience not only HIV-related discrimination and isolation but also prejudice against homosexuality [ 30 , 31 ].
Despite the fact that same-sex marriage has been allowed in many countries, homosexuality is still a controversial topic in Asia, and there is currently no Asian nation officially legalizing same-sex marriage [ 16 , 32 ]. Therefore, more study settings should be located in Asian developing countries, where the level of social judgement on the sex workers and LGBT community is relatively high, in order to demonstrate effective approaches to reach, test, and treat these key populations.
Most of the existing interventions are focused on reduction of risk behaviors and social stigma, rather than interventions that target the infected populations Figure 4. Since HIV is regarded as an incurable infection, it is essential to prevent incident HIV infections and the reduction of unprotected sex, injecting drugs, or substance abuse would lighten the global burden of HIV epidemic [ 33 ]. Additionally, stigma and discrimination, either perceived or self-stigma, is responsible for depressive symptoms in the majority of HIV-infected individuals [ 34 ].
Therefore, interventions addressing these problems would effectively lower the prevalence of HIV infection, in general, and depression among PLWH in particular. Although the field of depression in PLWH has been extensively studied, biomedical aspects of this research topic deserve more attention, since such research topics as viral load or immune responses currently hold relatively low positions Table 3.
In addition to psychological and somatic symptoms, biological factors also contribute to depression among HIV patients. A number of studies have recognized that chronic viral infections, including HIV, are able to affect immune system and influence the way the central nervous system mediates psychological status, resulting in neuropsychiatric consequences [ 35 , 36 ]. Biologically, HIV may trigger the release of inflammatory cytokines and induce sickness behaviors that are similar to depressive symptoms [ 37 ].
Additionally, while many antidepressants relieve the symptoms by elevating the level of a neurotransmitter called serotonin, HIV is capable of altering the precursor tryptophan and, thus, suppress the efficacy of the medications to a certain extent [ 38 , 39 ].
Evidences of neuronal damages have been recorded only a year after HIV infections and it been has reported that the use of antiviral therapies and the stage of the disease are associated with worsening depression [ 40 , 41 , 42 ].
There are several implications arising from the current study. Taking Thailand and Cambodia as the role models, developing countries could seek for investments from the U. Additionally, more studies should be set up in countries where the most-at-risk subjects commonly reside, such as Asian developing countries, in order to understand their nature, as well as the demographic characteristics and contextual factors, thus establishing more practical interventions.
On the other hand, the biological correlation between HIV infection and depression requires more intensive research, which may make a great contribution to the diagnostic procedure and treatments for depression among individuals suffering from HIV. Even though we introduced a novel approach in summarizing and analyzing the extant literature, some limitations should be acknowledged. First, the involved databases were limited to only the Web of Sciences.
Another limitation is that only publications in English were selected for this study. Additionally, the content analysis consisted solely of abstracts instead of full texts. Nevertheless, this modified bibliometric analysis puts forward a comprehensive overview of research trends as well as identifies current gaps in the literature of depression among PLWH.