Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy
Identifieur interne : 001120 ( Main/Exploration ); précédent : 001119; suivant : 001121Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy
Auteurs : Amara E. Ezeamama ; Makhabele N. Woolfork ; David Guwatudde ; Danstan Bagenda ; Yukari C. Manabe ; Wafaie W. Fawzi ; Mary C. Smith FawziSource :
- Medicine [ 0025-7974 ] ; 2016.
Abstract
The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period.
Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up.
QOL scores and SRH improved significantly for all participants over 18 months (
High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults.
Url:
DOI: 10.1097/MD.0000000000002525
PubMed: 26945347
PubMed Central: 4782831
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy</title><author><name sortKey="Ezeamama, Amara E" sort="Ezeamama, Amara E" uniqKey="Ezeamama A" first="Amara E" last="Ezeamama">Amara E. Ezeamama</name></author><author><name sortKey="Woolfork, Makhabele N" sort="Woolfork, Makhabele N" uniqKey="Woolfork M" first="Makhabele N" last="Woolfork">Makhabele N. Woolfork</name></author><author><name sortKey="Guwatudde, David" sort="Guwatudde, David" uniqKey="Guwatudde D" first="David" last="Guwatudde">David Guwatudde</name></author><author><name sortKey="Bagenda, Danstan" sort="Bagenda, Danstan" uniqKey="Bagenda D" first="Danstan" last="Bagenda">Danstan Bagenda</name></author><author><name sortKey="Manabe, Yukari C" sort="Manabe, Yukari C" uniqKey="Manabe Y" first="Yukari C" last="Manabe">Yukari C. Manabe</name></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name></author><author><name sortKey="Smith Fawzi, Mary C" sort="Smith Fawzi, Mary C" uniqKey="Smith Fawzi M" first="Mary C" last="Smith Fawzi">Mary C. Smith Fawzi</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26945347</idno><idno type="pmc">4782831</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782831</idno><idno type="RBID">PMC:4782831</idno><idno type="doi">10.1097/MD.0000000000002525</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000395</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000395</idno><idno type="wicri:Area/Pmc/Curation">000395</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000395</idno><idno type="wicri:Area/Pmc/Checkpoint">000790</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000790</idno><idno type="wicri:Area/Ncbi/Merge">003652</idno><idno type="wicri:Area/Ncbi/Curation">003652</idno><idno type="wicri:Area/Ncbi/Checkpoint">003652</idno><idno type="wicri:doubleKey">0025-7974:2016:Ezeamama A:depressive:and:anxiety</idno><idno type="wicri:Area/Main/Merge">001121</idno><idno type="wicri:Area/Main/Curation">001120</idno><idno type="wicri:Area/Main/Exploration">001120</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy</title><author><name sortKey="Ezeamama, Amara E" sort="Ezeamama, Amara E" uniqKey="Ezeamama A" first="Amara E" last="Ezeamama">Amara E. Ezeamama</name></author><author><name sortKey="Woolfork, Makhabele N" sort="Woolfork, Makhabele N" uniqKey="Woolfork M" first="Makhabele N" last="Woolfork">Makhabele N. Woolfork</name></author><author><name sortKey="Guwatudde, David" sort="Guwatudde, David" uniqKey="Guwatudde D" first="David" last="Guwatudde">David Guwatudde</name></author><author><name sortKey="Bagenda, Danstan" sort="Bagenda, Danstan" uniqKey="Bagenda D" first="Danstan" last="Bagenda">Danstan Bagenda</name></author><author><name sortKey="Manabe, Yukari C" sort="Manabe, Yukari C" uniqKey="Manabe Y" first="Yukari C" last="Manabe">Yukari C. Manabe</name></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name></author><author><name sortKey="Smith Fawzi, Mary C" sort="Smith Fawzi, Mary C" uniqKey="Smith Fawzi M" first="Mary C" last="Smith Fawzi">Mary C. Smith Fawzi</name></author></analytic><series><title level="j">Medicine</title><idno type="ISSN">0025-7974</idno><idno type="eISSN">1536-5964</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p>The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period.</p><p>Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up.</p><p>QOL scores and SRH improved significantly for all participants over 18 months (<italic>P</italic> < 0.0001). The gain in QOL increased dose-dependently as baseline depressive symptoms (time<sup>∗</sup>depression <italic>P</italic> < 0.001) and anxiety levels (time<sup>∗</sup>anxiety <italic>P</italic> < 0.001) declined. Lower social support was associated with worse QOL at baseline (<italic>P</italic> = 0.0005) but QOL improvement during follow-up was not dependent on baseline level of social support (time<sup>∗</sup>social support <italic>P</italic> = 0.8943) or number of stigmatizing experiences (time<sup>∗</sup>stigma <italic>P</italic> = 0.8662). Psychosocial determinants did not predict changes in SRH in this study.</p><p>High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Slomka, J" uniqKey="Slomka J">J Slomka</name></author><author><name sortKey="Lim, Jw" uniqKey="Lim J">JW Lim</name></author><author><name sortKey="Gripshover, B" uniqKey="Gripshover B">B Gripshover</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whetten, K" uniqKey="Whetten K">K Whetten</name></author><author><name sortKey="Reif, S" uniqKey="Reif S">S Reif</name></author><author><name sortKey="Whetten, R" uniqKey="Whetten R">R Whetten</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Souza Junior, Pr" uniqKey="Souza Junior P">PR Souza 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Ezeamama</name><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name><name sortKey="Guwatudde, David" sort="Guwatudde, David" uniqKey="Guwatudde D" first="David" last="Guwatudde">David Guwatudde</name><name sortKey="Manabe, Yukari C" sort="Manabe, Yukari C" uniqKey="Manabe Y" first="Yukari C" last="Manabe">Yukari C. Manabe</name><name sortKey="Smith Fawzi, Mary C" sort="Smith Fawzi, Mary C" uniqKey="Smith Fawzi M" first="Mary C" last="Smith Fawzi">Mary C. Smith Fawzi</name><name sortKey="Woolfork, Makhabele N" sort="Woolfork, Makhabele N" uniqKey="Woolfork M" first="Makhabele N" last="Woolfork">Makhabele N. Woolfork</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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