title: Incidence and Persistence of Major Depressive Disorder Among People Living with HIV in Uganda.
abstract: Data on the course of major depressive disorder (MDD) among people living with HIV (PLWH) are needed to inform refinement of screening and interventions for MDD. This paper describes the incidence and persistence rate of MDD in PLWH in Uganda. 1099 ART-naïve PLWH attending HIV clinics in Uganda were followed up for 12 months. MDD was assessed using the DSM IV based Mini-International Neuropsychiatric Interview with a prevalence for MDD at baseline of 14.0 % (95 % CI 11.7-16.3 %) reported. Multivariable logistic regression was used to determine predictors of incident and persistent MDD. Cumulative incidence of MDD was 6.1 per 100 person-years (95 % CI 4.6-7.8) with significant independent predictors of study site, higher baseline depression scores and increased stress. Persistence of MDD was 24.6 % (95 % CI 17.9-32.5 %) with independent significant predictors of study site, higher baseline depression scores, and increased weight. Risks of incident and persistent MDD observed in this study were high. Potentially modifiable factors of elevated baseline depressive scores and stress (only for incident MDD) were important predictors of incident and persistent MDD.
authors.affiliation: Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda. Eugene.Kinyanda@mrcuganda.org.|Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda. Eugene.Kinyanda@mrcuganda.org.|London School of Hygiene and Tropical Medicine, London, UK. Eugene.Kinyanda@mrcuganda.org.
authors.forename: Eugene
authors.identifier: http://orcid.org/0000-0001-7068-9294
authors.initials: E
authors.lastname: Kinyanda
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Levin
authors.affiliation: Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda.
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja
authors.affiliation: Butabika National Psychiatric Referral Hospital, Kampala, Uganda.
authors.forename: Harriet
authors.initials: H
authors.lastname: Birabwa
authors.affiliation: Butabika National Psychiatric Referral Hospital, Kampala, Uganda.
authors.forename: Juliet
authors.initials: J
authors.lastname: Nakku
authors.affiliation: Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
authors.forename: Richard
authors.initials: R
authors.lastname: Mpango
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
authors.affiliation: Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Araya
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
mesh_terms: D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013383:Suburban Population; D014454:Uganda / Q000453:epidemiology
keywords: HIV/AIDS; Incidence; Major depressive disorder; Persistence; Predictors