Анотація
In press
Епідемія ВІЛ-інфекції вражає всі соціальні групи населення. Біопсихосоціальні стресори, що безпосередньо пов’язані з ВІЛ-інфекцією, такі як стигма, дискримінація та сором, побічні ефекти лікування, симптоми ВІЛ-інфекції, розкриття діагнозу впливають на психічне здоров’я людей, які живуть з ВІЛ. Стигматизація та дискримінація можуть стояти на заваді вчасному зверненню за психіатричною допомогою. Соціальна стигматизація ВІЛ-інфекції, у свою чергу, може вплинути на їхню прихильність до антиретровірусної терапії. Метою нашого дослідження стало вивчення механізмів формування психічних розладів у людей, які живуть з ВІЛ. Проведене комплексне обстеження 118 пацієнтів, у яких діагностовано ВІЛ-інфекцію у віці від 22 до 61 року за допомогою клінічного інтерв’ю, опитувальника психопатологічної симптоматики Symptom Check List90-Revised, шкали депресії Бека, шкали особистісної та реактивної тривожності Спілбергера. В обстежених були виявлені органічні розлади настрою депресивні розлади, тривожні розлади; розлади пов’язані зі стресом і травмою. Результати опитувальників підтверджують різноманітність та широту виявленої клінічної симптоматики серед обстежених. У 55,9 % пацієнтів виявлені тяжкі симптоми психологічного дистресу. Така ж кількість обстежених демонструвала симптоми депресії різної вираженості за шкалою депресії Бека. В результаті дослідження виявлені ключові чинники психічних розладів у людей, що живуть з ВІЛ: низький рівень освіти, високий рівень безробіття, соціальна ізоляція та відсутність родинної підтримки, страх перед стигматизацією, наявність шкідливих звичок, стрес, пов'язаний з виявленням ВІЛ-інфекції.
Ключові слова: антиретровірусна терапія, депресія, нейрозапалення, психосоціальні фактори.
Посилання
Mental Health, Brain Health and Substance Use World Health Organization’s (WHO) Team. World mental health report: Transforming mental health for all – executive summary. Geneva: WHO; 2022. 28 p. Available at: https://www.who.int/publications/i/item/9789240049338
Global AIDS Monitoring 2019: Ukraine. UNAIDS; 2020. 6 p. Available at: https://www.unaids.org/sites/default/files/country/documents/UKR_2020_countryreport.pdf
Global HIV & AIDS statistics – Fact sheet. UNAIDS [Internet]. Available at: https://www.unaids.org/en/resources/fact-sheet [accessed 01 Apr 2024].
Smith CM, Kennedy JL, Evans ME, Person MK, Haverkate R, Apostolou A. Mental Illness in Adults With HIV and HCV Infection: Indian Health Service, 2001–2020. Am J Prev Med. 2022;63(3):e77-86. DOI: 10.1016/j.amepre.2022.03.023. PMID: 35589441.
Lopez CM, Baker NL, Moreland AD, Bisca E, Wilson T, Slick N, et al. Development and feasibility testing of an integrated PTSD and adherence intervention cognitive processing therapy-life steps (CPT-L) to improve HIV outcomes: Trial protocol. Contemp Clin Trials Commun. 2023;33:101150. DOI: 10.1016/j.conctc.2023.101150. PMID: 37273831.
Velo Higueras C, Martin-Bejarano Garcia M, Dominguez-Rodriguez S, Ruiz Saez B, Cuellar-Flores I, Garcia-Navarro C, et al. [Prevalence of psychological symptoms and associated risk factors in a Spanish sample of HIV-positive youth compared to uninfected peers]. An Pediatr (Engl Ed). 2020:S1695-4033(20)30489-6. DOI: 10.1016/j.anpedi.2020.05.028. PMID: 33390357. [In Spanish].
European Centre for Disease Prevention and Control. Operational considerations for the provision of the HIV continuum of care for refugees from Ukraine in the EU/EEA. 2022. Available at: https://www.ecdc.europa.eu/en/publications-data/operational-considerations-provision-hiv-continuum-care-refugees-ukraine-eueea
Lee ACK, Khaw FM, Lindman AES, Juszczyk G. Ukraine refugee crisis: evolving needs and challenges. Public Health. 2023;217:41-45. DOI: 10.1016/j.puhe.2023.01.016. PMID: 36848796.
Stockman JK, Lucea MB, Cimino AN, Wood BA, Tsuyuki K, Granger DA, Campbell JC. Discrimination, resilience, and HIV testing frequency among black women seeking services from STD clinics. Soc Sci Med. 2023;316:115344. DOI: 10.1016/j.socscimed.2022.115344. PMID: 36115729.
Bebell LM, Kembabazi A, Musinguzi N, Martin JN, Hunt PW, Boum Y 2nd, et al. Internalized stigma, depressive symptoms, and the modifying role of antiretroviral therapy: A cohort study in rural Uganda. SSM Ment Health. 2021;1:100034. DOI: 10.1016/j.ssmmh.2021.100034. PMID: 35252904.
Hsieh E, Polo R, Qian HZ, Fuster-RuizdeApodaca MJ, Del Amo J. Intersectionality of stigmas and health-related quality of life in people ageing with HIV in China, Europe, and Latin America. Lancet Healthy Longev. 2022;3(3):e206-15. DOI: 10.1016/S2666-7568(22)00003-4. PMID: 36098292.
Andalibi MS, Ellis RJ. The role of immunometabolism in HIV-associated depression and cognitive impairment. Chapter 11. P. 161-78. In: HIV-Associated Neurocognitive Disorders. 2024. DOI: 10.1016/B978-0-323-99744-7.00028-6.
Bershteyn A, Richard E, Zhou Q, Khan MR, Scheidell JD, Manandhar-Sasaki P, et al. Potential health benefits of integrated screening strategies for alcohol, tobacco, other substance use, depression, anxiety, and chronic pain among people living with HIV in the USA: a mathematical modelling study. Lancet HIV. 2023;10(2):118-25. DOI: 10.1016/S2352-3018(22)00361-7. PMID: 36731986.
Mudra Rakshasa-Loots A, Whalley HC, Vera JH, Cox SR. Neuroinflammation in HIV-associated depression: evidence and future perspectives. Mol Psychiatry. 2022;27(9):3619-32. DOI: 10.1038/s41380-022-01619-2. PMID: 35618889.
Gruchot J, Herrero F, Weber-Stadlbauer U, Meyer U, Kury P. Interplay between activation of endogenous retroviruses and inflammation as common pathogenic mechanism in neurological and psychiatric disorders. Brain Behav Immun. 2023;107:242-52. DOI: 10.1016/j.bbi.2022.10.007. PMID: 36270439.
Nettis MA. Minocycline in Major Depressive Disorder: And overview with considerations on treatment-resistance and comparisons with other psychiatric disorders. Brain Behav Immun Health. 2021;17:100335. DOI: 10.1016/j.bbih.2021.100335. PMID: 34568852.
Hellmann-Regen J, Clemens V, Grozinger M, Kornhuber J, Reif A, Prvulovic D, et al. Effect of Minocycline on Depressive Symptoms in Patients With Treatment-Resistant Depression: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(9):e2230367. DOI: 10.1001/jamanetworkopen.2022.30367. PMID: 36103181.
Bianchin MM, Snow Z. Primary Microglia Dysfunction or Microgliopathy: A Cause of Dementias and Other Neurological or Psychiatric Disorders. Neuroscience. 2022;497:324-39. DOI: 10.1016/j.neuroscience.2022.06.032. PMID: 35760218.
Keegan MR, Chittiprol S, Letendre SL, Winston A, Fuchs D, Boasso A, et al. Tryptophan Metabolism and Its Relationship with Depression and Cognitive Impairment Among HIV-infected Individuals. Int J Tryptophan Res. 2016;9:79-88. DOI: 10.4137/IJTR.S36464. PMID: 27812290.
Martinez P, Tsai AC, Muzoora C, Kembabazi A, Weiser SD, Huang Y,et al. Reversal of the Kynurenine pathway of tryptophan catabolism may improve depression in ART-treated HIV-infected Ugandans. J Acquir Immune Defic Syndr. 2014;65(4):456-62. DOI: 10.1097/QAI.0000000000000062. PMID: 24220289.
Marcus JL, Leyden WA, Alexeeff SE, Anderson AN, Hechter RC, Hu H, et al. Comparison of Overall and Comorbidity-Free Life Expectancy Between Insured Adults With and Without HIV Infection, 2000-2016. JAMA Netw Open. 2020;3(6):e207954. DOI: 10.1001/jamanetworkopen.2020.7954. PMID: 32539152.
Morillo-Verdugo R, Polo R, Knobel H. Consensus document on enhancing medication adherence in patients with the human immunodeficiency virus receiving antiretroviral therapy. Farm Hosp. 2020;44(4):163-73. DOI: 10.7399/fh.11441. PMID: 32646348. [In English].
Schrock JM. Accelerated aging in people living with HIV: The neuroimmune feedback model. Brain Behav Immun Health. 2024;36:100737. DOI: 10.1016/j.bbih.2024.100737. PMID: 38356933.
Breen EC, Sehl ME, Shih R, Langfelder P, Wang R, Horvath S, et al. Accelerated aging with HIV begins at the time of initial HIV infection. iScience. 2022;25(7):104488. DOI: 10.1016/j.isci.2022.104488. Erratum in: iScience. 2023;26(8):107381. DOI: 10.1016/j.isci.2023.107381. PMID: 35880029.
Liu Z, Chen X, Li J, Xie Z, Huang Y, Luo D. HIV-related stress predicts depression over five years among people living with HIV. Front Public Health. 2023;11:1163604. DOI: 10.3389/fpubh.2023.1163604. PMID: 37377546.
Parro-Torres C, Hernandez-Huerta D, Ochoa-Mangado E, Perez-Elias MJ, Baca-Garcia E, Madoz-Gurpide A. Antiretroviral treatment adherence and mental disorders: observational case-control study in people living with HIV in Spain. AIDS Care. 2022;34(8):1064-72. DOI: 10.1080/09540121.2021.1944598. PMID: 34165358.
Smith W. Understanding the Nuances of Managing PTSD and Cognitive Impairment in Aging Adults Living with HIV. The American Journal of Geriatric Psychiatry. 2024;32(4):35. DOI: 10.1016/j.jagp.2024.01.102.
Brennan-Ing M, Mattas E. Aging with HIV: Working to Ensure Equity and Inclusion. Gerontology. 2023;69(8):946-52. DOI: 10.1159/000530723. PMID: 37071979.
Brown MJ, Cohen SA, DeShazo JP. Psychopathology and HIV diagnosis among older adults in the United States: disparities by age, sex, and race/ethnicity. Aging Ment Health. 2020;24(10):1746-53. DOI: 10.1080/13607863.2019.1636201. PMID: 31274001.
Gianella S, Saloner R, Curtin G, Little SJ, Heaton A, Montoya JL, et al. A Cross-Sectional Study to Evaluate the Effects of Age and Duration of HIV Infection on Anxiety and Depression in Cisgender Men. AIDS Behav. 2022;26(1):196-203. DOI: 10.1007/s10461-021-03373-y. Erratum in: AIDS Behav. 2022;26(1):204. DOI: 10.1007/s10461-021-03421-7. PMID: 34287757.
Petersen KJ, Lu T, Wisch J, Roman J, Metcalf N, Cooley SA,et al. Effects of clinical, comorbid, and social determinants of health on brain ageing in people with and without HIV: a retrospective case-control study. Lancet HIV. 2023;10(4):e244-53. DOI: 10.1016/S2352-3018(22)00373-3. Erratum in: Lancet HIV. 2023;10(12):e762. DOI: 10.1016/S2352-3018(23)00056-5. PMID: 36764319.
Zhu Z, Guo M, Dong T, Han S, Hu Y, Wu B. Assessing psychological symptom networks related to HIV-positive duration among people living with HIV: a network analysis. AIDS Care. 2022;34(6):725-33. DOI: 10.1080/09540121.2021.1929815. PMID: 34043459.
Huang Y, Luo D, Chen X, Zhang D, Huang Z, Xiao S. HIV-Related Stress Experienced by Newly Diagnosed People Living with HIV in China: A 1-Year Longitudinal Study. Int J Environ Res Public Health. 2020;17(8):2681. DOI: 10.3390/ijerph17082681. PMID: 32295107.
Babicz MA, Woods SP, Fazeli P, Morgan EE. Apathy is Associated with Critical Psychological Determinants of Medication Adherence in HIV Disease. J Clin Psychol Med Settings. 2021;28(2):301-12. DOI: 10.1007/s10880-020-09715-7. PMID: 32253661.
Jaqua E, Labib W, Danji K. HIV-Associated Conditions in Older Adults. Cureus. 2022;14(12):e32661. DOI: 10.7759/cureus.32661. PMID: 36660505.
Liboro RM, Yates TC, Bell S, Ranuschio B, Da Silva G, Fehr C, et al. Protective Factors That Foster Resilience to HIV/AIDS: Insights and Lived Experiences of Older Gay, Bisexual, and Other Men Who Have Sex with Men. Int J Environ Res Public Health. 2021;18(16):8548. DOI: 10.3390/ijerph18168548. PMID: 34444297.
Ojukwu EN, Phillips JC, Vance DE, Caine V. Thinking with Community: A Critique of Resilience and Well-being. J Assoc Nurses AIDS Care. 2022;33(2):99-102. DOI: 10.1097/JNC.0000000000000328. PMID: 35120073.
Vorobyova A, Van Tuyl R, Cardinal C, Marante A, Magagula P, Lyndon S, et al. "I’m positively positive": Beyond individual responsibility for resilience amongst older adults living with HIV. SSM – Qualitative Research in Health. 2022;2:100192. DOI:10.1016/j.ssmqr.2022.100192.
Suen YT. A qualitative study of older people living with HIV Hong Kong: Resilience through downward comparison amidst limited social support. J Aging Stud. 2023;64:101079. DOI: 10.1016/j.jaging.2022.101079. PMID: 36868626.
Folayan MO, Ibigbami O, Lusher J. Associations between resilience, self-esteem, HIV status, and sexual identity among residents in Nigeria. Sci Afr. 2022;17:e01333. DOI: 10.1016/j.sciaf.2022.e01333.
Li X, Yan H, Wang W, Yang H, Li S. Association between enacted stigma, internalized stigma, resilience, and depressive symptoms among young men who have sex with men in China: a moderated mediation model analysis. Ann Epidemiol. 2021;56:1-8. DOI: 10.1016/j.annepidem.2021.01.001. PMID: 33422600.
Cluver LD, Sherr L, Toska E, Zhou S, Mellins CA, Omigbodun O, et al.; Adolescent Advisory Groups in South Africa, Kenya, Sierra Leone, and Uganda. From surviving to thriving: integrating mental health care into HIV, community, and family services for adolescents living with HIV. Lancet Child Adolesc Health. 2022;6(8):582-92. DOI: 10.1016/S2352-4642(22)00101-8. PMID: 35750063.
Filiatreau LM, Ebasone PV, Dzudie A, Ajeh R, Pence BW, Wainberg M,et al. Prevalence of stressful life events and associations with symptoms of depression, anxiety, and post-traumatic stress disorder among people entering care for HIV in Cameroon. J Affect Disord. 2022;308:421-31. DOI: 10.1016/j.jad.2022.04.061. PMID: 35452755.
Ng'ong'a GO, Lwembe RM, Knight V, Randa D, Sciborski RJ, Ayodo G. Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya. Scientific African. 2023;20:e01598. 2020. DOI: 10.1016/j.sciaf.2023.e01598.
Gomez R, Stavropoulos V, Zarate D, Palikara O. Symptom Checklist-90-Revised: A structural examination in relation to family functioning. PLoS One. 2021;16(3):e0247902. DOI: 10.1371/journal.pone.0247902. PMID: 33711019.
Sereda Y, Dembitskyi S. Validity assessment of the symptom checklist SCL-90-R and shortened versions for the general population in Ukraine. BMC Psychiatry. 2016;16(1):300. DOI: 10.1186/s12888-016-1014-3. PMID: 27561313.
Asrat B, Schneider M, Ambaw F, Lund C. Effectiveness of psychological treatments for depressive symptoms among people living with HIV/AIDS in low- and middle-income countries: A systematic review and meta-analysis. J Affect Disord. 2020;270:174-87. DOI: 10.1016/j.jad.2020.03.068. PMID: 32339109.
Guajardo E, Giordano TP, Westbrook RA, Black WC, Njue-Marendes S, Dang BN. The Effect of Initial Patient Experiences and Life Stressors on Predicting Lost to Follow-Up in Patients New to an HIV Clinic. AIDS Behav. 2022;26(6):1880-91. DOI: 10.1007/s10461-021-03539-8. PMID: 34984580.
Wang Yu-P, Gorenstein C. The Beck depression inventory: Uses and applications. Chapter 16. P. 165-74. In: Martin CR, Hunter L-A, Patel VB, Preedy VR, Rajendram R (Eds). The Neuroscience of Depression. Features, Diagnosis, and Treatment. Academic Press; 2021. DOI: 10.1016/B978-0-12-817933-8.00020-7.
Knowles KA, Olatunji BO. Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory. Clin Psychol Rev. 2020;82:101928. DOI: 10.1016/j.cpr.2020.101928. PMID: 33091745.
Ця робота ліцензується відповідно до Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.