title: Discrepancies between physician's perception of depression in HIV patients and self-reported CES-D-20 assessment: the DHIVA study.
abstract: Depression in HIV/AIDS patients affects adherence and disease progression and often goes unnoticed. DHIVA is a cross-sectional epidemiologic survey, investigating the prevalence of depression in people living with HIV through use of a validated self-administered scale (CES-D-20), as well and the degree of concordance between the physician's perception and patients' reports. A total of 690 HIV-infected patients attending 24 centers across Italy were enrolled. Concordance was calculated by K statistics. Association between depression and subject characteristics were evaluated through univariate and multivariate logistic models (OR and 95%CI). The prevalence of depressive symptoms was 48.8% from patient's questionnaires and 49.5% from physicians' reports, with a low/fair concordance (K = .38, p < .001). CES-D-20 found severe depression in 22.5% of the patients vs 4% identified by physicians. 135/155 (87%) of the severely depressed patients (according to CES-D-20) were considered as non or mildly/moderately depressed by physicians. Risk of severe depression was associated with unemployment (p < .001), previous depression (p < .001), treatment failure (p = .001), and former smoking status (p = .018). Depression is frequent in HIV-infected patients in the HAART era, with significant discrepancy between physician perception and the self-reported CES-D-20 results. Screening should be mandatory in all HIV patients.
authors.affiliation: a Abbvie s.r.l. , Campoverde, LT , Italy.
authors.forename: F
authors.initials: F
authors.lastname: Marando
authors.affiliation: a Abbvie s.r.l. , Campoverde, LT , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gualberti
authors.affiliation: a Abbvie s.r.l. , Campoverde, LT , Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Costanzo
authors.affiliation: a Abbvie s.r.l. , Campoverde, LT , Italy.
authors.forename: U
authors.initials: U
authors.lastname: di Luzio Paparatti
authors.affiliation: b Infectious Diseases Unit , University of Milan , L. Sacco Hospital, Milan , Italy.
authors.forename: M
authors.initials: M
authors.lastname: Franzetti
authors.affiliation: c Istituto Nazionale Malattie Infettive L. Spallanzani , Rome , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ammassari
authors.affiliation: c Istituto Nazionale Malattie Infettive L. Spallanzani , Rome , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.affiliation: b Infectious Diseases Unit , University of Milan , L. Sacco Hospital, Milan , Italy.
authors.forename: M
authors.initials: M
authors.lastname: Galli
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D003865:Major Depressive Disorder; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D057566:Self Report
keywords: CES-D-20 scale; Depression; HIV; psychological evaluation