A comparison of the prevalence and clinical features of depression in HIVpositive and HIVnegative elderly patients in Uganda

Caroline Birungi; Fred Semitala; Seggane Musisi; Noeline Nakasujja

Volume : V, Issue : VIII, August - 2016

A comparison of the prevalence and clinical features of depression in HIVpositive and HIVnegative elderly patients in Uganda

Caroline Birungi, Fred Semitala, Seggane Musisi, Noeline Nakasujja

Abstract :

BackgroundDepression is a leading contributor to the burden of disease worldwide, a serious co morbidity and critical barrier to Human Immunodeficiency Virus (HIV) care and prevention especially in Sub– Saharan Africa. It is unclear if among elderly HIV/ Acquired Immune Deficiency Syndrome (AIDS) positive individuals the characteristics of the illness presents different as compared to elderly HIV/AIDS negative individuals. We thus set out to compare the prevalence and clinical features associated with depression among elderly HIV positive and elderly HIV negative patients in Mulago Hospital. Methods ?is was a comparative cross sectional study of HIV positive and HIV negative individuals aged ≥ 60 years. ?ey were enrolled from the Assessment Centre and the AIDS clinic in Mulago Hospital. ?e Geriatric Depression Scale was used to screen for depression, any individual score of ≥10, had the diagnosis of depression confirmed using the Mini–International Neuropsychiatric Interview. Data was entered using ACCESS data –base and analyzed using STATA version 11.0 software. Cross tabulations were done for the two groups using means, chi–squares and frequencies. Univariate, logistic regression, and multivariate analysis were done to determine clinical features associated with depression. Results Of 940 elderly patients screened, 238(26.4%) had depression symptom scores ≥ 10. ?e mean age was 66.8, SD 6.07. ?e prevalence of major depression was higher among the HIV positive elderly (57%) compared to the HIV negative elderly individuals (22%). However, the prevalence of Dysthymia and adjustment disorder with depressed mood were higher among the HIV negative compared to the HIV positive elderly (68.9% versus 50.4%) and (8.4% versus 1.7%) respectively. ?e HIV positive depressed were more likely to report suicidal ideation (p< 0.04), sleep problems (p<0.03), feeling tired (p<0.04) and feelings of worthlessness (P<0.01).Conclusion?e clinical presentation of depression differs among HIV positive and HIV negative elderly individuals. ?is requires a difference in approach and care strategies related to HIV and depression in the elderly. ?ese findings call for routine screening and treatment of depressive illnesses in all HIV infected elderly individuals especially the late onset depressive illness