Religion, spirituality, and depressive symptoms in patients with HIV/AIDS

Abstract

BACKGROUND: Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well‐being has been linked to increased risk for depression and other mood disorders in patients with HIV. OBJECTIVE: We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi‐center cohort of patients with HIV/AIDS. DESIGN: Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10‐item Center for Epidemiologic Studies Depression (CESD‐10) Scale. Independent variables included socio‐demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self‐esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms. MEASUREMENTS AND MAIN RESULTS: We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty‐one (53.6%) fit the criteria for significant depressive symptoms (CESD‐10 score ≥10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV‐related symptoms, less social support, and lower spiritual well‐being was associated with significant depressive symptoms (P<.05). CONCLUSION: A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well‐being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.

Prevalencia, factores de riesgo y manejo de la depresión en pacientes con infección por VIH: Revisión de la literatura

“…Al igual a lo descrito para la población general, los pacientes con mayor riesgo de desarrollar depresión son los de sexo femenino, aquellos con menor nivel educacional y socioeconómico, los desempleados o en condiciones de inestabilidad laboral, los no casados ni emparejados, y aquellos que no cuentan con una red de apoyo social 2,4,5,8,9,[21][22][23][24][25] . Junto a esto, se considera que los pacientes con mayores preocupaciones respecto a su situación de salud, con mayor incomodidad respecto a la forma en que contrajeron el VIH, así como con menos creencias religiosas o espirituales, presentarían mayor vulnerabilidad a la depresión 11,24,25 .…”

“…Junto a esto, se considera que los pacientes con mayores preocupaciones respecto a su situación de salud, con mayor incomodidad respecto a la forma en que contrajeron el VIH, así como con menos creencias religiosas o espirituales, presentarían mayor vulnerabilidad a la depresión 11,24,25 . Otro grupo particularmente vulnerable a desarrollar depresión sería el de los hombres homosexuales, aunque algunos estudios indican que la prevalencia de depresión entre éstos sería la misma que para los hombres homosexuales seronegativos 2,4 .…”

“…Una estrategia posible de utilizar sería el tamizaje periódico de síntomas depresivos mediante algún instrumento estandarizado, tal como el Inventario de depresión de Beck (BDI) 54 o la Escala de depresión del Centro de Estudios Epidemiológicos (CES-D) 55 , que han sido ampliamente utilizados en pacientes infectados por VIH, lo que permite identificar a aquellos pacientes que requieren mayor evaluación y eventual tratamiento antidepresivo 3,7,12,22,25,27,56 . Es esencial que los médicos clínicos que tratan pacientes seropositivos para VIH se familiaricen con el diagnóstico de la depresión, conozcan el enfoque terapéutico, manejen el tratamiento inicial, estén al tanto de las posibles interacciones medicamentosas entre psicotrópicos y anti-retrovirales y conozcan los criterios de derivación a especialistas en psiquiatría.…”

A systematic review: the role of spirituality in reducing depression in people living with HIV/AIDS

“…Systematic literature searches of PubMed, PsycInfo, and Embase were carried out, along with backwards and forwards citation tracking of key studies, identified 21 qualitative studies, of which five studies [6][7][8][9][10] met the predetermined criteria for eligibility and were included in the review. Formal meta-analysis was not possible due to the nature of the studies.…”

Exploring the Multivariate Relationships between Adolescent Depression and Social Support, Religiosity, and Spirituality in a Faith-Based High School

“…Spirituality refers to the sense of well-being that arises from values such as compassion, love, forgiveness, and one's relationship with God, people, nature, and the meaning found in these relationships and life experiences [34] [35]. Studies have repeatedly demonstrated a negative association between depression and spirituality [36] [37]. The negative correlation found between spirituality and depression may be due to greater spiritual well-being which not only facilitates more positive and healthy personal and social behaviors, but provides a unifying framework that helps individuals cope with unexpected and difficult life situations [37].…”