RESUMO
Depression and anxiety are the most common mental disorder affecting individuals with human immunodeficiency virus (HIV) infection. Anxiety is highly prevalent in HIV infected individuals in clinical studies. Early identification and treatment of depression and anxiety in patients may improve better outcome of ART Therapy. We wanted to evaluate the prevalence of depression and anxiety among HIV patients taking antiretroviral therapy and examine the predicting effect of depression and anxiety with demographics on CD4 count. MethodsThis study was conducted in the ART Plus center in Department of Medicine, PT JNM Medical college, Raipur, Chhattisgarh and Dr. Bhim Rao Ambedkar Memorial Hospital between July 2018 and June 2019. A total of 300 patients who were enrolled in the ART plus center, gave consent to participate in study. Participants were selected in systematic random sampling method irrespective of their age, gender, ethnicity, socio-economic status, occupation, education, and present CD4 count. Starting CD4 count was assessed on enrolment to ART center and present CD4 count repeated at the time of recruitment to our study. Depression was evaluated using Hamilton Depression Rating Scale and anxiety was measured by Hamilton Anxiety Rating Scale by a Psychiatrist. ResultsThe first model showed 8.8% of total variance (R= .297, R2=.088; F (5, 298) = 5.683; p<0.01) for starting CD4 count and second model showed 6.7% of total variance (R=.259, R2=.067; F (5, 298) = 4.221; p<0.01) for present CD4 count with five predictor variables (depression, treatment year, gender, age, anxiety). Depression of the patients was negatively associated with starting CD4 count (-.085, p<0.01) before starting ART Regimen. Treatment year of the patients was positively associated with present CD4 count (-.085, p<0.01). ConclusionsThe study demonstrates high prevalence of anxiety and depression among HIV positive patients taking antiretroviral therapy (ART) and strong correlation of depression and anxiety and its associated factors among HIV positive patients taking ART. High depression reported lower level of CD4 count before starting ART regimen.
RESUMO
Mobile application-based delivery of mental health awareness programs may help in reducing the knowledge gap in mental healthcare in India. Apps can be used to educate our community about mental health first aid protocols. Apps have shown effectiveness in high-income settings, but they suffer from lack of applicability in low resource scenarios due to challenges of availability of apps in local vernaculars and digital illiteracy. We wanted to determine the potential of technology usage in mental healthcare awareness. We also wanted to explore the acceptability and willingness of caregivers in using mobile based mental health apps.METHODSA cross-sectional quantitative survey was conducted in outpatient setting of Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, in which a semi structured questionnaire was provided electronically to collect data. A total of 120 participants, including 60 caregivers of mentally ill patients and rest 60 caregivers of patients suffering from diseases other than mental illness were included in the study. All 120 participants were included for data calculation. Data obtained was analysed statistically, using Cross Tab Analysis which includes chi-square and Cramer’s V with the help of SPSS (16th) version.RESULTSOut of 120 participants, 85 (70.83%) use smart phone with internet facility. 34 (28.33%) participants already use internet as their primary source of health-related information. 42 (35%) cases and 30 (25%) controls were keen to learn about Mental Health First Aid (MHFA) protocols. Those who had a mentally ill patient in their family were more likely to use a MHFA learning App (Pearson chi square = 11.528; df = 4; p = 0.02 < 0.05; Cramer’s V = 0.031; p= >0.021). There was no significant difference in both the groups’ eagerness to help their loved ones after learning MHFA protocols. Lack of knowledge and awareness and unavailability of an appropriate app were significant barriers.CONCLUSIONSThe study looks into the scope and limitations of implementing a mobile technology-based intervention for low resource setting. Handholding of caregivers and frequent encouragement from treating doctors might significantly help in technology adoption and in surmounting the apprehension related to using technology. The scope of delivering mental health services through technology is immense.