The factor structure and presentation of depression among HIV-positive adults in Uganda.

Journal: AIDS and behavior

Volume: 19

Issue: 1

Year of Publication: 2015

Affiliated Institutions:  Department of Psychiatry, Behavioral Medicine Service, Massachusetts General Hospital, One Bowdoin Square, th Floor, Boston, MA, , USA, cpsaros@partners.org.

Abstract summary 

Depression is one of the most prevalent psychiatric comorbidities of HIV and one of the greatest barriers to HIV self-care and adherence. Despite this, little consensus exists on how to best measure depression among people living with HIV/AIDS (PLWHA) in African settings. Measurement of depression among PLWHA may be confounded by somatic symptoms. Some research recommends excluding these items to enhance measurement validity; sensitivity may be lost with this approach. We sought to characterize depression among a cohort (N = 453) of PLWHA initiating antiretroviral therapy in Uganda via factor analysis of a widely used measure of depression, the Hopkins Symptom Checklist (HSCLD). Common factor analysis was performed, associations between HSCLD and the Mental Health subscale of the Medical Outcomes Study HIV (MOS-HIV) estimated, and a Cronbach's alpha calculated to examine validity. Factor analysis yielded two factors: (1) somatic-cognitive symptoms and (2) behavioral disengagement. Persons with more versus less advanced disease (CD4 cell count of ≤200 cells/mm(3)) showed no statistically significant differences in depression scores (1.7 vs. 1.7, P ≥ 0.5). Both factors were significantly associated with the MOS-HIV (P < .01). Factor one was highly reliable (α = .81); factor two had only modest reliability (α = .65). Somatic-cognitive symptoms of depression and disengagement from life's activities appear to be distinct components of depression in this sample. Consideration of somatic items may be valuable in identifying depression in this setting.

Authors & Co-authors:  Psaros Christina C Haberer Jessica E JE Boum Yap Y Tsai Alexander C AC Martin Jeffrey N JN Hunt Peter W PW Bangsberg David R DR Safren Steven A SA

Study Outcome 

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Statistics
Citations :  Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012;380(9859):2197–223.
Authors :  8
Identifiers
Doi : 10.1007/s10461-014-0796-x
SSN : 1573-3254
Study Population
Male,Female
Mesh Terms
Adaptation, Psychological
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States