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Erschienen in: International Journal of Behavioral Medicine 4/2017

10.02.2017

Effects of Depression Alleviation on Work Productivity and Income Among HIV Patients in Uganda

verfasst von: Glenn J. Wagner, Bonnie Ghosh-Dastidar, Eric Robinson, Victoria K. Ngo, Peter Glick, Seggane Musisi, Dickens Akena

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 4/2017

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Abstract

Purpose

Depression is common among people living with HIV, and it is associated with impaired work functioning. However, little research has examined whether depression alleviation improves work-related outcomes in this population, which is the focus of this analysis.

Method

A sample of 1028 depressed HIV clients in Uganda enrolled in a comparative trial of depression care models and were surveyed over 12 months. Serial regression analyses examined whether depression alleviation (measured by the nine-item Patient Health Questionnaire) was associated with change in self-reported weekly amount of hours worked and income earned, and whether these relationships were mediated by change in work-related self-efficacy.

Results

Among those with major depression, depression alleviation was associated with nearly a doubling of weekly hours worked in bivariate analysis. The relationship between depression alleviation and hours worked was partially mediated by change in work self-efficacy among those with major depression, as well as those with minor depression, in multivariate regression analysis that controlled for demographic and health covariates. Depression alleviation was not significantly associated with change in weekly income.

Conclusion

These findings suggest that depression alleviation benefits work functioning at least in part through improved confidence to engage in work-related activities. Integration of depression care services into HIV care may be important for improving the economic well-being of people living with HIV.
Literatur
1.
Zurück zum Zitat UNAIDS. HIV and AIDS Uganda country progress report 2014. UNAIDS. HIV and AIDS Uganda country progress report 2014.
2.
Zurück zum Zitat Brandt R. The mental health of people living with HIV/AIDS in Africa: a systematic review. Af J AIDS Res. 2009;8:123–33.CrossRef Brandt R. The mental health of people living with HIV/AIDS in Africa: a systematic review. Af J AIDS Res. 2009;8:123–33.CrossRef
3.
Zurück zum Zitat Myer L, Smit J, Le Roux LL, Parker S, Stein DJ, Seedat S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDs. 2008;22:147–57.CrossRefPubMed Myer L, Smit J, Le Roux LL, Parker S, Stein DJ, Seedat S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDs. 2008;22:147–57.CrossRefPubMed
4.
Zurück zum Zitat Bolton P, Wilk CM, Ndogoni L. Assessment of depression prevalence in rural Uganda using symptom and function criteria. Soc Psychiatry Psychiatr Epidemiol. 2004;39:442–7.CrossRefPubMed Bolton P, Wilk CM, Ndogoni L. Assessment of depression prevalence in rural Uganda using symptom and function criteria. Soc Psychiatry Psychiatr Epidemiol. 2004;39:442–7.CrossRefPubMed
5.
Zurück zum Zitat Ickovics JR, Hamburger ME, Vlhaov, Schoenbaum EE, Schuman P, Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV sero-positive women: longitudinal analysis from the HIV epidemiology research study. JAMA. 2001;285:1466–74.CrossRefPubMed Ickovics JR, Hamburger ME, Vlhaov, Schoenbaum EE, Schuman P, Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV sero-positive women: longitudinal analysis from the HIV epidemiology research study. JAMA. 2001;285:1466–74.CrossRefPubMed
6.
Zurück zum Zitat Evans DL, Ten Have TR, Douglas SD, Gettes DR, Morrison M, Chiappini MS, et al. Association of depression with viral load, CD8 T lymphocytes, and natural killer cells in women with HIV infection. Am J Psychiatry. 2002;159:1752–9.CrossRefPubMed Evans DL, Ten Have TR, Douglas SD, Gettes DR, Morrison M, Chiappini MS, et al. Association of depression with viral load, CD8 T lymphocytes, and natural killer cells in women with HIV infection. Am J Psychiatry. 2002;159:1752–9.CrossRefPubMed
7.
Zurück zum Zitat Lima VD, Geller J, Bangsberg DR, Patterson TL, Daniel M, Kerr T, et al. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS. 2007;21:1175–83.CrossRefPubMed Lima VD, Geller J, Bangsberg DR, Patterson TL, Daniel M, Kerr T, et al. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS. 2007;21:1175–83.CrossRefPubMed
8.
Zurück zum Zitat Antelman G, Kaaya S, Ruilan W, Mbwambo J, Msamanga GI, Fawzi WW, et al. Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. J Acquir Immune Defic Syndr. 2007;44:470–7.CrossRefPubMed Antelman G, Kaaya S, Ruilan W, Mbwambo J, Msamanga GI, Fawzi WW, et al. Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. J Acquir Immune Defic Syndr. 2007;44:470–7.CrossRefPubMed
9.
Zurück zum Zitat Anastos K, Schneider M, Gange S, Minkoff H, Greenblatt RM, Fedlman J, et al. The association of race, sociodemographic, and behavioral characteristics with response to highly active antiretroviral therapy in women. J Acquir Immune Defic Syndr. 2005;39:537–44.PubMed Anastos K, Schneider M, Gange S, Minkoff H, Greenblatt RM, Fedlman J, et al. The association of race, sociodemographic, and behavioral characteristics with response to highly active antiretroviral therapy in women. J Acquir Immune Defic Syndr. 2005;39:537–44.PubMed
10.
Zurück zum Zitat Pence BW, Miller WC, Gaynes BN, Eron JJ. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;44:159–66.CrossRefPubMed Pence BW, Miller WC, Gaynes BN, Eron JJ. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;44:159–66.CrossRefPubMed
11.
Zurück zum Zitat Wagner GJ, Holloway I, Ghosh-Dastidar B, Kityo C, Mugyenyi P. Understanding the influence of depression on self-efficacy, work status and condom use among HIV clients in Uganda. J Psychosom Res. 2011;70(5):440–8.CrossRefPubMed Wagner GJ, Holloway I, Ghosh-Dastidar B, Kityo C, Mugyenyi P. Understanding the influence of depression on self-efficacy, work status and condom use among HIV clients in Uganda. J Psychosom Res. 2011;70(5):440–8.CrossRefPubMed
12.
Zurück zum Zitat Preau M, Bonnet A, Bouhnik AD, Fernandez L, Obadia Y, Spire BB. VESPA. Anhedonia and depressive symptomatology among HIV-infected patients with highly active antiretroviral therapies (ANRS-EN12-VESPA). Encéphale. 2008;34(4):385–93.CrossRefPubMed Preau M, Bonnet A, Bouhnik AD, Fernandez L, Obadia Y, Spire BB. VESPA. Anhedonia and depressive symptomatology among HIV-infected patients with highly active antiretroviral therapies (ANRS-EN12-VESPA). Encéphale. 2008;34(4):385–93.CrossRefPubMed
13.
Zurück zum Zitat Uganda Bureau of Statistics. Employment and labor report. 2016. Uganda Bureau of Statistics. Employment and labor report. 2016.
14.
Zurück zum Zitat World Bank. World Bank Indicators Statistics. Rural Poverty Portal: Uganda; 2012. World Bank. World Bank Indicators Statistics. Rural Poverty Portal: Uganda; 2012.
15.
Zurück zum Zitat UNICEF. State of the world’s children 2015 country statistical tables. UNICEF. State of the world’s children 2015 country statistical tables.
16.
Zurück zum Zitat Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.CrossRefPubMed Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.CrossRefPubMed
17.
Zurück zum Zitat Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020. Global Burden Dis Study Lancet. 1997;349:1498–504. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020. Global Burden Dis Study Lancet. 1997;349:1498–504.
18.
Zurück zum Zitat Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011;378:1502–14.CrossRefPubMed Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011;378:1502–14.CrossRefPubMed
19.
Zurück zum Zitat Wagner GJ, Ngo VK, Nakasujja N, Akena D, Aunon F, Musisi S. Impact of antidepressant therapy on cognitive aspects of work, condom use and psychosocial well-being among HIV clients in Uganda. Int J Psychiatry Med. 2014;48(3):155–66.CrossRefPubMed Wagner GJ, Ngo VK, Nakasujja N, Akena D, Aunon F, Musisi S. Impact of antidepressant therapy on cognitive aspects of work, condom use and psychosocial well-being among HIV clients in Uganda. Int J Psychiatry Med. 2014;48(3):155–66.CrossRefPubMed
20.
Zurück zum Zitat Wagner GJ, Ngo V, Ghosh-Dastidar B, Robinson E, Glick P, Musisi S, et al. A cluster randomized controlled trial of two task-shifting depression care models on depression alleviation and antidepressant response among HIV clients in Uganda. Res Adv Psychiatry. 2016;3:12–21. Wagner GJ, Ngo V, Ghosh-Dastidar B, Robinson E, Glick P, Musisi S, et al. A cluster randomized controlled trial of two task-shifting depression care models on depression alleviation and antidepressant response among HIV clients in Uganda. Res Adv Psychiatry. 2016;3:12–21.
21.
Zurück zum Zitat Wagner GJ, Ngo V, Glick P, Obuku E, Musisi S, Akena D. INtegration of DEPression Treatment into HIV care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial. Trials. 2014;15:248.CrossRefPubMedPubMedCentral Wagner GJ, Ngo V, Glick P, Obuku E, Musisi S, Akena D. INtegration of DEPression Treatment into HIV care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial. Trials. 2014;15:248.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat American Psychiatric Association. Diagnostic statistical manual of mental disorders. 4th ed. Washington: American Psychiatric Association; 1994. American Psychiatric Association. Diagnostic statistical manual of mental disorders. 4th ed. Washington: American Psychiatric Association; 1994.
24.
Zurück zum Zitat Monahan PO, Shacham E, Reece M, Kroenke K, Ong’or WO, Omollo O, et al. Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. J Gen Intern Med. 2009;24:189–97.CrossRefPubMed Monahan PO, Shacham E, Reece M, Kroenke K, Ong’or WO, Omollo O, et al. Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. J Gen Intern Med. 2009;24:189–97.CrossRefPubMed
25.
Zurück zum Zitat Rush A, Fava M, Wisniewski S, Lavori PW, Trivedi MH, Sackeim HA, et al. Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Control Clin Trials. 2004;25:119–42.CrossRefPubMed Rush A, Fava M, Wisniewski S, Lavori PW, Trivedi MH, Sackeim HA, et al. Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Control Clin Trials. 2004;25:119–42.CrossRefPubMed
26.
Zurück zum Zitat Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13:290–312.CrossRef Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13:290–312.CrossRef
27.
Zurück zum Zitat Bodner TE. What improves with increased missing data imputations? Struct Equ Model Multidiscip J. 2008;15:651–75.CrossRef Bodner TE. What improves with increased missing data imputations? Struct Equ Model Multidiscip J. 2008;15:651–75.CrossRef
28.
Zurück zum Zitat Graham JW, Olchowski AE, Gilreath TD. How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prev Sci. 2007;8:206–13.CrossRefPubMed Graham JW, Olchowski AE, Gilreath TD. How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prev Sci. 2007;8:206–13.CrossRefPubMed
29.
Zurück zum Zitat Wagner GJ, Ghosh-Dastidar B, Slaughter M, Akena D, Nakasujja N, Okello E, et al. The role of depression in work-related outcomes of HIV treatment in Uganda. Int J Behav Med. 2014;21(6):946–55.CrossRefPubMedPubMedCentral Wagner GJ, Ghosh-Dastidar B, Slaughter M, Akena D, Nakasujja N, Okello E, et al. The role of depression in work-related outcomes of HIV treatment in Uganda. Int J Behav Med. 2014;21(6):946–55.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Yan T, Curtin R, Jans M. Trends in income nonresponse over two decades. J Off Stat. 2010;26:145–64. Yan T, Curtin R, Jans M. Trends in income nonresponse over two decades. J Off Stat. 2010;26:145–64.
31.
Zurück zum Zitat Yun LW, Maravi MBS, Kobayashi JS, Barton PL, Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr. 2005;38:432–8.57.CrossRefPubMed Yun LW, Maravi MBS, Kobayashi JS, Barton PL, Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr. 2005;38:432–8.57.CrossRefPubMed
32.
Zurück zum Zitat Akincigil A, Wilson IB, Walkup JT, Siegel MJ, Huang C, Crystal S. Antidepressant treatment and adherence to antiretroviral medications among privately insured persons with HIV/AIDS. AIDS Behav. 2011;15:1819–28.CrossRefPubMedPubMedCentral Akincigil A, Wilson IB, Walkup JT, Siegel MJ, Huang C, Crystal S. Antidepressant treatment and adherence to antiretroviral medications among privately insured persons with HIV/AIDS. AIDS Behav. 2011;15:1819–28.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Wagner GJ, Ghosh-Dastidar B, Robinson E, Ngo VK, Glick P, Mukasa B, et al. Effects of depression alleviation on ART adherence and HIV clinic attendance in Uganda, and the mediating roles of self-efficacy and motivation. AIDS Behav; in press. Wagner GJ, Ghosh-Dastidar B, Robinson E, Ngo VK, Glick P, Mukasa B, et al. Effects of depression alleviation on ART adherence and HIV clinic attendance in Uganda, and the mediating roles of self-efficacy and motivation. AIDS Behav; in press.
34.
Zurück zum Zitat Wagner GJ, Ngo V, Goutam P, Glick P, Musisi S, Akena D. A structured protocol model of depression care versus clinical acumen: a cluster randomized trial of the effects on depression screening, diagnostic evaluation, and treatment uptake in Ugandan HIV clinics. PLoS One. 2016;11(5):e0153132.CrossRefPubMedPubMedCentral Wagner GJ, Ngo V, Goutam P, Glick P, Musisi S, Akena D. A structured protocol model of depression care versus clinical acumen: a cluster randomized trial of the effects on depression screening, diagnostic evaluation, and treatment uptake in Ugandan HIV clinics. PLoS One. 2016;11(5):e0153132.CrossRefPubMedPubMedCentral
Metadaten
Titel
Effects of Depression Alleviation on Work Productivity and Income Among HIV Patients in Uganda
verfasst von
Glenn J. Wagner
Bonnie Ghosh-Dastidar
Eric Robinson
Victoria K. Ngo
Peter Glick
Seggane Musisi
Dickens Akena
Publikationsdatum
10.02.2017
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 4/2017
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-017-9642-7

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