title: Effectiveness of antidepressants and predictors of treatment response for depressed HIV patients in Uganda.
abstract: Antidepressant medication is well established for the treatment of depression but little is known about its effectiveness for HIV populations in sub-Saharan Africa. This study examined the effectiveness of antidepressant treatment and predictors of treatment response among depressed HIV patients in Uganda. Data were obtained from two open-label trials in which 184 HIV patients were diagnosed with depression and started on antidepressants. Data at treatment baseline and month 6 were compared to assess treatment response, and baseline predictors of response were assessed. A total of 154 completed month 6, of whom 122 (79%) had responded to treatment and were no longer depressed (Patient Health Questionnaire-9, score < 5). Bivariate analysis found that education, CD4 count, general health functioning, physical health, pain, quality of life and social support variables were associated with antidepressant treatment response; however, only secondary education and social support independently predicted treatment response in logistic multiple regression analysis. Baseline depression severity was not associated with treatment response. In conclusion, antidepressants are effective in treating both moderate and more severe depression among persons living with HIV in Uganda, and education [OR (95% CI) = 4.33 (1.33-14.11)] and social support [OR (95% CI) = 1.54 (1.03-2.30)] were most predictive of treatment response.
authors.affiliation: RAND Corporation, Santa Monica, CA, USA vngo@rand.org.
authors.forename: Victoria K
authors.initials: VK
authors.lastname: Ngo
authors.affiliation: RAND Corporation, Santa Monica, CA, USA.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
authors.affiliation: Department of Psychiatry, Makerere University, Kampala, Uganda.
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja
authors.affiliation: Department of Psychiatry, Makerere University, Kampala, Uganda.
authors.forename: Akena
authors.initials: A
authors.lastname: Dickens
authors.affiliation: RAND Corporation, Santa Monica, CA, USA.
authors.forename: Frances
authors.initials: F
authors.lastname: Aunon
authors.affiliation: Department of Psychiatry, Makerere University, Kampala, Uganda.
authors.forename: Seggane
authors.initials: S
authors.lastname: Musisi
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents
keywords: AIDS; Depression; HIV; Uganda; antidepressant medication; predictors of treatment response