Prevalence of depressive symptoms and associated factors among people who inject drugs in China.
BACKGROUND
People who inject drugs (PWID) have a high prevalence of mental health problems (e.g., depression) which compromise the effects of HIV prevention. We investigated the prevalence of depression and associated factors among PWID in Dazhou, China.


METHODS
Anonymous face-to-face interviews were administered to eligible participants by well-trained doctors. The Center of Epidemiological Studies Depression Scale (CES-D) was used to measure depression, using hierarchical linear regression models.


RESULTS
Among the 257 participants, 7.0%, 11.3%, and 75.1% were probable cases of mild (16 ≤ CES-D < 21), moderate (21 ≤ CES-D < 25), and severe (CES-D ≥ 25) depression, respectively. Hopefulness (standardized β = -0.34, p < 0.001) and emotional family support (β = -0.21, p < 0.001) were negatively associated, whereas severity of drug dependence (β = 0.12, p = 0.034) and unmet service needs (β = 0.20, p < 0.001) were positively associated, respectively, with CES-D scores. The adjusted analysis showed that resilience was negatively associated with CES-D, but it was not selected by the stepwise model containing hopefulness and emotional family support. Protective factors (i.e., hopefulness and emotional family support) and risk factors (i.e., severity of drug dependence and unmet service needs) remained significant in the same regression model.


CONCLUSIONS
Protective and risk factors were independently associated with depressive symptoms. Integrated interventions covering basic and psychosocial needs for PWID are warranted. Such interventions should strengthen emotional family support and cultivate positive factors such as hopefulness.
Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
Jinghua
J
Li
School of Public Health, Sun Yat-sen University, Guangzhou, China.
Jing
J
Gu
Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China. Electronic address: jlau@cuhk.edu.hk.
Joseph T F
JT
Lau
Dazhou Center for Disease Control and Prevention, Sichuan, China.
Hongyao
H
Chen
Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
Phoenix K H
PK
Mo
Dazhou Center for Disease Control and Prevention, Sichuan, China.
Mei
M
Tang
D000328:Adult; D002681:China / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D055500:Resilience, Psychological; D012307:Risk Factors; D012923:Social Class; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult
Depression; Family support; Hopefulness; People who inject drugs; Resilience; Unmet service needs