Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study

Choi, Stephanie; Boyle, Eleanor; Cairney, John; Collins, Evan; Gardner, Sandra; Bacon, Jean; Rourke, Sean B.

doi:10.1371/journal.pone.0165816

Cited by 20 publications

(17 citation statements)

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“…However, the CES‐D has been previously used in studies of PLWH [39], including the MACS [40], and is a standardized tool for the assessment of depressive symptoms with good reliability and validity. Prior studies in PLWH have demonstrated an association of female sex with depression and depressive symptoms and with worse executive functioning in the setting of depression [41–43], but we were not able to explore that association. Because our study was cross‐sectional, we did not assess the temporal relationship between depressive symptoms and diabetes in MLWH.…”

Section: Discussionmentioning

confidence: 84%

The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

et al. 2020

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The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. Methods Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100-125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. Results Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). Conclusions Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.

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Section: Discussionmentioning

confidence: 84%

The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

et al. 2020

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“…The RPDB, which contains Ontario vital statistics data, was used to obtain OCS participants’ dates of death [ 19 ]. Details about the linked data source have been provided in recent studies [ 5 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…Current depression and recreational drug use status were measured at baseline and at each follow-up interview during the five-year study period. As described in recent articles, due to resource-constraints at several participating HIV clinics, K 10 was administered to 61% of OCS participants and the CES-D 20 was administered to the rest [ 5 , 20 ]. The excellent reliability and diagnostic accuracy of these two screening instruments have been validated in a sample of OCS participants when compared to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria for major depression [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…When selecting covariates in each multivariable regression model, we adopted a method similar to a recent study [ 20 ]. Briefly, we used backward selection method [ 27 – 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…For each final explanatory multivariable model, we controlled for differences between the CES-D 20 and K 10 as well as the residual difference of OCS participants’ characteristics by clinic type [ 20 ]. In addition, we tested proportionality assumptions in each final model using Schoenfeld residuals against time for each of the covariates and interactions with linear time and natural log of time [ 27 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

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Impact of depression and recreational drug use on emergency department encounters and hospital admissions among people living with HIV in Ontario: A secondary analysis using the OHTN cohort study

et al. 2018

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IntroductionNearly half of HIV-positive patients experience mental health and substance use problems, but many do not receive adequate or ongoing mental health or addiction care. This lack of ongoing care can result in the use of costly acute care services. Prospective evaluations of the relationship between psychiatric and substance use disorders and acute care services use are lacking, and this information is needed to understand unmet needs and improve access to appropriate services.MethodsWe conducted a secondary data analysis from a multicenter, longitudinal, prospective cohort study (n = 3,482 adults) between October 1, 2007 and March 31, 2013. We used explanatory extended Cox proportional hazard regression models to examine the impact of current depression and recreational drug use on acute care services use, and to explore whether current depression and recreational drug use were associated with potentially avoidable acute care services use.ResultsOver our 5.5 year study period, HIV-positive participants with current depression-only (aHR [95% CI]:1.2[1.1–1.4]), recreational drug use-only (1.3[1.1–1.6]), or co-occurring depression and recreational drug use (1.4[1.2–1.7]) were associated with elevated hazard of emergency department (ED) encounters compared to participants without these conditions. Over half of ED encounters were potentially avoidable. Participants with current depression-only (1.3[1.1–1.5];1.3[1.03–1.6]), recreational drug use-only (1.3[1.04–1.6];1.5[1.1–1.9]), or co-occurring depression and recreational drug use (1.3[1.04–1.7];1.4[1.06–1.9]) were associated with elevated hazard of low-acuity or repeated ED encounters respectively.ConclusionsWe found a significant increase in ED services use and potentially avoidable ED encounters (including low-acuity or repeated ED encounters), particularly among those with either current depression or recreational drug use. These findings emphasize the challenges in managing HIV and mental health/addiction co-morbidities in the current HIV care model. Future research should evaluate integrated and collaborative care programs for improving the coordination of care and effectively treat mental health and addiction problems among HIV-positive patients in Ontario.

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Impact of Food Insecurity on Depressive Symptoms Among HIV–HCV Co-infected People

et al. 2017

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Food insecurity (FI) is associated with depressive symptoms among HIV mono-infected people. Our objective was to examine to what extent this association holds among HIV-hepatitis C virus (HCV) co-infected people. We used data from a prospective cohort study of HIV-HCV co-infected people in Canada. FI was measured using the ten-item adult scale of Health Canada's Household Food Security Survey Module and was classified into three categories: food secure, moderate FI, and severe FI. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10) and was classified into absence or presence of depressive symptoms. FI, depressive symptoms, and other covariates were updated every 6 months. The association between FI and depressive symptoms was assessed using a stabilized inverse probability weighted marginal structural model. The study sample included 725 HIV-HCV co-infected people with 1973 person-visits over 3 years of follow up. At baseline, 23% of participants experienced moderate food insecurity, 34% experienced severe food insecurity and 52% had depressive symptoms. People experiencing moderate FI had 1.63 times (95% CI 1.44-1.86) the risk of having depressive symptoms and people experiencing severe FI had 2.01 times (95% CI 1.79-2.25) the risk of having depressive symptoms compared to people who were food secure. FI is a risk factor for developing depressive symptoms among HIV-HCV co-infected people. Food supplementation, psychosocial support and counseling may improve patient health outcomes.

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Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study

Cited by 20 publications

References 70 publications

The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

Impact of depression and recreational drug use on emergency department encounters and hospital admissions among people living with HIV in Ontario: A secondary analysis using the OHTN cohort study

Impact of Food Insecurity on Depressive Symptoms Among HIV–HCV Co-infected People

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