广东省初治HIV/AIDS患者焦虑抑郁状况及其影响因素

Anxiety and depression and influencing factors in na?ve HIV/AIDS patients in Guangdong Province

目的了解初治HIV/AIDS患者焦虑、抑郁情绪状况及其影响因素,为提高HIV感染者的心理健康提供理论依据。方法采用连续性抽样方法,以2019年1月至2020年9月在广州某艾滋病定点医院门诊就诊,拟开展ART的初治HIV/AIDS患者为研究对象,采用焦虑自评量表(HAD-A)和抑郁自评量表(HAD-D)测评其焦虑及抑郁状况,使用多因素Logistic回归分析其影响因素。结果共入组1337例初治HIV/AIDS患者,年龄为33.8(26.4,47.2)岁。出现焦虑症状139例(10.4%),HAD-A量表得分为5(2,8)分;出现抑郁症状140例(10.5%),HAD-D量表得分为5(2,8)分;同时出现焦虑和抑郁症状53例(4.0%)。多因素分析显示,从事高强度脑力工作(OR=0.552,95CI:0.358~0.851)、有抑郁史(OR=0.204,95CI:0.121~0.343)和睡眠质量差(OR=9.229,95CI:3.072~27.723)是焦虑发生的影响因素;年龄(OR=2.685,95CI:1.260~5.723)、从事高强度脑力工作(OR=1.846,95CI:1.101~3.091)、有抑郁史(OR=0.413,95CI:0.234~0.728)和睡眠质量差(OR=10.722,95CI:3.904~29.448)是抑郁发生的影响因素。结论初治HIV/AIDS患者治疗前存在一定程度的焦虑、抑郁症状,尤其是老年人、有抑郁史、从事高强度脑力工作和睡眠质量下降的人群,医护人员应注意识别,选择合适抗病毒药物并给予针对性干预。

Objective To explore the pre-treatment anxiety and depression situation and influencing factors among people living with HIV(PLWH)who are eligible for antiretroviral therapy to provide basis for improving the mental health among PLWH.Methods The continuous sampling method was used to recruit PLWH who planned to initiate the antiretroviral treatment in an AIDS hospital in Guangzhou from January 2019 to September 2020.The Hospital Anxiety and Depression Scale(HAD)was used to evaluate their anxiety and depression.Multivariate Logistic regression was used to analyze the influencing factors.Results A total of 1,337 PLWH were enrolled,with a median age of 33.8(26.4,47.2)years.Anxiety symptoms occurred in 139 cases(10.4%),with a median score of 5(2,8)on the HAD-A scale.140 cases(10.5%)had depressive symptoms,with a median score on the HAD-D scale of 5(2,8)points.53 cases(4.0%)reported to have anxiety and depression symptoms at the same time.Multivariate analysis showed being engaged in mental works(OR=0.552,95CI:0.358-0.851),having a history of depression(OR=0.204,95CI:0.121-0.343)and having a poor sleep quality(OR 9.229,95CI:3.072-27.723)were risk factors for anxiety occurrence.Age(OR 2.685,95CI:1.260-5.723),being engaged in mental works(OR 1.846,95CI:1.101-3.091),with a history of depression(OR 0.413,95CI:0.234-0.728),and having a poor sleep quality(OR 10.722,95CI:3.904-29.448)were risk factors for depression.Conclusions PLWH tended to have certain degrees of anxiety and depression before ART initiation,especially among PLWH who were at elderly age,having a history of depression,being engaged in mental works,with a poor sleep quality.Our research provided valuable reference to the selection of appropriate antiviral drugs and development of tailored interventions.