Predictors of receiving a diagnosis, referral and treatment of depression in people on antiretroviral therapy in South African primary care: a secondary analysis of data from a randomised trial.

Journal: Tropical medicine & international health : TM & IH

Volume: 25

Issue: 12

Year of Publication: 2021

Affiliated Institutions:  Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa. Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa. Centre for Global Mental Health, King's College London, London, UK. HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa. Norwich Medical School, University of East Anglia, Norwich, UK.

Abstract summary 

To describe the receipt of a diagnosis, referral and treatment for depression in people receiving antiretroviral therapy (ART), with depressive symptoms and attending primary care clinics in South Africa, and investigate factors associated with receiving these components of care.This is a secondary analysis of data from a randomised controlled trial of an intervention intended to improve detection and treatment of depression in primary care patients receiving ART. In this analysis, we combined cross-sectional and longitudinal data from the intervention and control arms. Using regression models and adjusting for intra-cluster correlation of outcomes, we investigated associations between socioeconomic characteristics, depressive symptoms, stress, disability and stigma, and receipt of a diagnosis, referral and treatment for depression.Of 2002 participants enrolled, 18% reported a previous diagnosis of depression by a healthcare worker and 10% reported having received counselling from a specialist mental health worker. Diagnosis, referral and counselling during the follow-up period were appropriately targeted, being independently more frequent in participants with higher enrolment scores for depressive symptoms, stress or disability. Participants with higher stigma scores at enrolment were independently less likely to receive counselling. Severe socio-economic deprivation was common but was not associated with treatment.While the receipt of a diagnosis, referral and treatment for depression were uncommon, they seemed to be appropriately targeted. Socio-economic deprivation was not associated with treatment.

Authors & Co-authors:  Zani B B Fairall L L Petersen I I Folb N N Bhana A A Thornicroft G G Hanass-Hancock J J Lund C C Bachmann M M

Study Outcome 

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Statistics
Citations :  Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry 2016: 3: 171–178.
Authors :  10
Identifiers
Doi : 10.1111/tmi.13495
SSN : 1365-3156
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
antiretroviral therapy;depression diagnosis;depression treatment;disability;multimorbidity;stigma
Study Design
Case Control Trial,Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England