title: Depression and posttraumatic stress disorder among HIV-infected Gambians on antiretroviral therapy.
abstract: Mood disorders are more frequent among people with HIV infection than among non-HIV-infected individuals of the same age, socioeconomic status, and HIV risks. They have been associated with worse adherence and clinical outcomes, yet remain underdiagnosed and undertreated in sub-Saharan Africa. We explored the relationship between mood disorders using the 10-item depression scale of the Centers for Epidemiological Studies (CES-D10) and the 22-item Impact of Events Scale-Revised (IES-R) for posttraumatic stress disorder, and a range of demographic and HIV-related variables among 252 consecutive subjects on antiretroviral therapy (ART). The study was conducted in the Genito-Urinary Medicine Clinic of the Medical Research Council's Gambia Unit. These screening tests were positive in 7% and 30%, respectively, of the patients, with higher scores (more depression or more post-traumatic stress) associated with female gender, more advanced WHO clinical stage, and lower Karnofsky Perfomance Scale rating. Higher CES-D10 scores were also seen among those on their second ART regimen. No relationship was seen with age, time on ART, viral load, or CD4 cell count. Compared to an earlier study at the same site in subjects prior to starting ART, the prevalence of depression in those stabilized on ART was dramatically reduced (by 34%, from 41%) while that of PTSD dropped less (by 13%, from 43%). Integrating the CES-D10 or a similar instrument into patient preparation for ART is recommended in order to identify those who may benefit from further mental health investigations, specific therapy, or closer follow-up during early ART.
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. kpeterson@itg.be
authors.forename: Kevin
authors.initials: K
authors.lastname: Peterson
authors.forename: Toyin
authors.initials: T
authors.lastname: Togun
authors.forename: Sandor
authors.initials: S
authors.lastname: Klis
authors.forename: Joris
authors.initials: J
authors.lastname: Menten
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D005714:Gambia / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D019562:Viral Load; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents