Psychiatric comorbidity and psychosocial stressors among people initiating HIV care in Cameroon.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
15
09
2021
accepted:
03
06
2022
entrez:
30
6
2022
pubmed:
1
7
2022
medline:
6
7
2022
Statut:
epublish
Résumé
Psychiatric comorbidity, the presence of two or more mental health disorders, has been associated with suboptimal HIV treatment outcomes. Little is known about the prevalence of psychiatric comorbidity among people with HIV (PWH) in sub-Saharan Africa. We conducted interviews with PWH initiating HIV care in Cameroon between June 2019 and March 2020. Depression, anxiety, post-traumatic stress disorder (PTSD), and harmful drinking were dichotomized to represent those with and without symptoms of each. Psychiatric comorbidity was defined as having symptoms of two or more disorders assessed. Moderate or severe household hunger, high anticipatory HIV-related stigma, low social support, and high number of potentially traumatic events were hypothesized as correlates of psychiatric comorbidity. Bivariable log binomial regression models were used to estimate unadjusted associations between psychosocial stressors and psychiatric comorbidity. Among 424 participants interviewed, the prevalence of psychiatric comorbidity was 16%. Among those with symptoms of at least one mental health or substance use disorder (n = 161), the prevalence of psychiatric comorbidity was 42%. The prevalence of psychiatric comorbidity was 33%, 67%, 76%, and 81% among those with symptoms of harmful drinking, depression, anxiety, and PTSD, respectively. Among individuals with symptoms of a mental health or substance use disorder, a high number of potentially traumatic events (prevalence ratio (PR) 1.71 [95% CI 1.21, 2.42]) and high anticipatory HIV-related stigma (PR 1.45 [95% CI 1.01, 2.09]) were associated with greater prevalence of psychiatric comorbidity. Psychiatric comorbidity was common among this group of PWH in Cameroon. The effectiveness and implementation of transdiagnostic or multi-focus mental health treatment approaches in HIV care settings should be examined.
Sections du résumé
BACKGROUND
Psychiatric comorbidity, the presence of two or more mental health disorders, has been associated with suboptimal HIV treatment outcomes. Little is known about the prevalence of psychiatric comorbidity among people with HIV (PWH) in sub-Saharan Africa.
METHODS
We conducted interviews with PWH initiating HIV care in Cameroon between June 2019 and March 2020. Depression, anxiety, post-traumatic stress disorder (PTSD), and harmful drinking were dichotomized to represent those with and without symptoms of each. Psychiatric comorbidity was defined as having symptoms of two or more disorders assessed. Moderate or severe household hunger, high anticipatory HIV-related stigma, low social support, and high number of potentially traumatic events were hypothesized as correlates of psychiatric comorbidity. Bivariable log binomial regression models were used to estimate unadjusted associations between psychosocial stressors and psychiatric comorbidity.
RESULTS
Among 424 participants interviewed, the prevalence of psychiatric comorbidity was 16%. Among those with symptoms of at least one mental health or substance use disorder (n = 161), the prevalence of psychiatric comorbidity was 42%. The prevalence of psychiatric comorbidity was 33%, 67%, 76%, and 81% among those with symptoms of harmful drinking, depression, anxiety, and PTSD, respectively. Among individuals with symptoms of a mental health or substance use disorder, a high number of potentially traumatic events (prevalence ratio (PR) 1.71 [95% CI 1.21, 2.42]) and high anticipatory HIV-related stigma (PR 1.45 [95% CI 1.01, 2.09]) were associated with greater prevalence of psychiatric comorbidity.
CONCLUSION
Psychiatric comorbidity was common among this group of PWH in Cameroon. The effectiveness and implementation of transdiagnostic or multi-focus mental health treatment approaches in HIV care settings should be examined.
Identifiants
pubmed: 35771857
doi: 10.1371/journal.pone.0270042
pii: PONE-D-21-29941
pmc: PMC9246197
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0270042Subventions
Organisme : NIMH NIH HHS
ID : K01 MH114721
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI096299
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMC Public Health. 2018 Jan 15;18(1):138
pubmed: 29334959
J Gen Intern Med. 2009 Feb;24(2):189-97
pubmed: 19031037
AIDS Care. 2011 Apr;23(4):426-34
pubmed: 21271395
Afr Health Sci. 2009 Aug 1;9 Suppl 1:S35-41
pubmed: 20589159
AIDS Behav. 2021 Dec;25(12):4018-4028
pubmed: 34091803
Alcohol Alcohol. 2017 May 01;52(3):318-327
pubmed: 28003244
BMC Psychiatry. 2014 Jun 17;14:180
pubmed: 24938124
J Clin Psychiatry. 2000;61 Suppl 7:22-32
pubmed: 10795606
PLoS One. 2016 Oct 10;11(10):e0161645
pubmed: 27723815
PLoS One. 2015 Apr 27;10(4):e0125096
pubmed: 25915929
Addiction. 1993 Jun;88(6):791-804
pubmed: 8329970
J Affect Disord. 2012 Dec 20;143(1-3):208-13
pubmed: 22840467
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
AIDS Behav. 2017 Aug;21(8):2509-2518
pubmed: 28634661
Soc Sci Med. 2012 Jun;74(12):2012-9
pubmed: 22513248
Alcohol Alcohol. 2005 Nov-Dec;40(6):575-7
pubmed: 16115823
PLoS One. 2019 Oct 31;14(10):e0224515
pubmed: 31671160
Afr J AIDS Res. 2009 Jun;8(2):123-33
pubmed: 25875564
Psychosom Med. 2008 May;70(4):505-11
pubmed: 18378865
AIDS Behav. 2018 Oct;22(10):3141-3154
pubmed: 29460130
J Consult Clin Psychol. 1991 Dec;59(6):906-15
pubmed: 1774375
Cogn Behav Pract. 2014 May;21(2):111-123
pubmed: 25620867
AIDS Care. 2005 Jul;17(5):550-7
pubmed: 16036241
Med Confl Surviv. 2012 Oct-Dec;28(4):289-316
pubmed: 23421305
AIDS Behav. 2019 Mar;23(3):707-741
pubmed: 30298241
BMJ Open. 2016 Jul 13;6(7):e011453
pubmed: 27412106
Arch Gen Psychiatry. 2005 Jun;62(6):617-27
pubmed: 15939839
Behav Res Ther. 2020 Jul;130:103430
pubmed: 31780251
Womens Health Issues. 2019 Sep - Oct;29(5):376-384
pubmed: 31303419
J Trauma Stress. 2015 Dec;28(6):489-98
pubmed: 26606250
PLoS One. 2012;7(5):e36304
pubmed: 22606252
PLoS Med. 2020 Apr 17;17(4):e1003056
pubmed: 32302308
AIDS Behav. 2019 Dec;23(12):3444-3451
pubmed: 31297682
BMC Psychiatry. 2011 Dec 30;11:205
pubmed: 22208452
BMC Psychiatry. 2018 Apr 23;18(1):109
pubmed: 29685117
AIDS. 2020 Sep 1;34 Suppl 1:S73-S82
pubmed: 32881796
JAMA Psychiatry. 2018 Apr 1;75(4):336-346
pubmed: 29450462
J Affect Disord. 2011 Feb;128(3):277-86
pubmed: 20692043
Depress Res Treat. 2020 Dec 09;2020:6633686
pubmed: 33489371
JAMA Psychiatry. 2019 Mar 1;76(3):259-270
pubmed: 30649197
AIDS Care. 2014;26(12):1482-9
pubmed: 24991994
AIDS Behav. 2012 Nov;16(8):2091-100
pubmed: 22249954
AIDS Behav. 2008 Jul;12(4):605-12
pubmed: 17968651
J Int AIDS Soc. 2019 Jul;22(7):e25341
pubmed: 31328891
BMC Psychiatry. 2018 Aug 16;18(1):259
pubmed: 30115040
Soc Sci Med. 2010 Jan;70(1):35-44
pubmed: 19833427
AIDS Behav. 2019 Nov;23(11):2904-2915
pubmed: 30798459
AIDS Behav. 2009 Dec;13(6):1160-77
pubmed: 19636699
AIDS Care. 2019 Jan;31(1):117-124
pubmed: 30304947
J Antimicrob Chemother. 2009 Apr;63(4):636-40
pubmed: 19153077
PLoS Med. 2014 Nov 11;11(11):e1001757
pubmed: 25386945
J Affect Disord. 2016 Jul 1;198:50-5
pubmed: 27011359
AIDS Behav. 2019 Sep;23(9):2432-2442
pubmed: 31218545
J Child Adolesc Ment Health. 2017 May;29(1):11-26
pubmed: 28287023
AIDS Res Ther. 2020 Jun 22;17(1):36
pubmed: 32571426
AIDS Behav. 2012 Nov;16(8):2101-18
pubmed: 22116638
BMJ Glob Health. 2019 Mar 19;4(2):e001285
pubmed: 30997170
J Affect Disord. 2014 Dec;169:203-11
pubmed: 25212996
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
AIDS Behav. 2017 Jan;21(1):274-282
pubmed: 27052843
Curr HIV/AIDS Rep. 2015 Dec;12(4):397-405
pubmed: 26419376
J Clin Psychol Med Settings. 2016 Jun;23(2):160-80
pubmed: 26868222
AIDS Behav. 2018 Oct;22(10):3155-3165
pubmed: 29476437
J Int AIDS Soc. 2020 Dec;23(12):e25654
pubmed: 33340267
AIDS Care. 2013;25(10):1245-52
pubmed: 23398282