抗病毒治疗HIV/AIDS患者抑郁状况及其影响因素分析

Analysis of Depression and Influencing Factors in HIV/AIDS Patients Receiving Antiviral Therapy

【目的】了解接受抗病毒治疗HIV/AIDS患者抑郁状况及其影响因素。【方法】2022年7月-2022年9月,采用连续抽样法从南京市抗病毒治疗机构招募接受抗病毒治疗HIV/AIDS患者,进行匿名问卷调查,收集患者基本信息,采用患者健康问卷抑郁量表(PHQ-9)、简化的Berger艾滋病感知歧视量表(BHSS)及感知社会支持的多维度量表(MSPSS)调查抑郁状况、HIV耻辱得分以及社会支持水平等。采用多因素Logistic回归分析患者抑郁的影响因素。【结果】本研究共收集有效问卷1879份,抑郁检出率为50.1%,多因素logistic回归分析结果显示:相较于初中及以下文化程度的患者,研究生及以上文化程度抑郁的风险更低[OR=0.534,95%CI(0.341,0.835),P=0.006];相较于抗病毒治疗时长<1年,抗病毒治疗时长1~5年[OR=0.729,95%CI(0.536,0.991)]、>5~10年[OR=0.516,95%CI(0.379,0.702)]、>10年[OR=0.603,95%CI(0.375,0.969)]抑郁的风险更低;相较于中低社会支持水平,高社会支持水平是HIV/AIDS患者抑郁保护性因素[OR=0.430,95%CI(0.349,0.530),P<0.001];相较于未存在治疗药物副作用,存在药物副作用发生抑郁的风险更高[OR=2.260,95%CI(1.833,2.786),P<0.001];同时在HIV耻辱感量表得分越高,抑郁的可能性越高。【结论】南京市抗病毒治疗患者抑郁检出率较高,启动抗病毒治疗后应加强患者的药物副作用及心理状态监测,开展心理干预,缓解心理问题出现,提高患者的生命质量。

【Objective】To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.【Methods】From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.【Results】A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.【Conclusion】The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.