A comparison of the clinical features of depression in hiv-positive and hiv-negative patients in Uganda

ABSTRACT

Objective: Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 3 times higher than the general population. It's still questionable whether HIV related depression is clinically different from depression in HIV-negative populations; a fact that could have treatment implications.This study compared the clinical features of major depression between HIV-Positive and HIV-negative patients with a view to intervention strategies. Method: A comparative; descriptive; cross-sectional study was carried out on 64 HIV-Positive depressed patients and 66 HIV-negative depressed patients in Butabika and Mulago hospitals. They were compared along the parameters of clinical features of depression; physical examination and laboratory findings. Pair wise comparisons; logistic regression and Multivariate analysis were done for the two groups on a number of variables. Results: Compared to HIV-Negative patients; HIV-Positive patients were more likely to be widowed ; older (? 30years); less likely to have a family member with a mental illness; a later onset of depressive illness (?30years); more likely to have a medical illness and taking medication before onset of depressive; symptomatically compared to HIV-Negative patients; HIV-Positive patients were more critical of themselves ; had significantly more problems making decisions ; had poorer sleep; felt more easily tired; more appetite changes; more cognitive impairment. Low CD4 counts were not significantly associated with depression; but HIV related depression was more likely to occur in stages II and III illness. Conclusion: These findings show that the clinical and associated features of depression differ between HIV-Positive and HIV-Negative patients; thus requiring different management approaches and further studies related to HIV-related depression