HIV感染者/AIDS患者情绪问题及其相关因素分析

目的：了解长沙市新确认的HIV感染者/AIDS患者情绪问题发生现状并分析其相关因素，为更好地开展 该人群的精神卫生服务提供基础数据。方法：将2013年3月1日至2014年2月28日在长沙市艾滋病综合防治信息系统 中新确认登记的、符合入组条件的感染者/患者作为连续样本，在知情同意的原则下，采用病人健康问卷抑郁量表 (PHQ-9)、广泛性焦虑量表(GAD-7)、社会支持评定量表(SSRS)及艾滋病压力量表(HIV/AIDS Stress Scale)进行调查。 结果：370例HIV感染者/AIDS患者的抑郁阳性率为40.3%(PHQ-9≥10分)，焦虑阳性率为30.5%(GAD-7≥10分)。重 度抑郁症状(PHQ-9≥20分)及重度焦虑症状(GAD-7≥15分)分别占8.1%，14.3%。分层回归分析结果显示：工作状况 (b=–3.407，P<0.001；b=–2.799，P=0.001)、性取向(b=1.903，P=0.008；b=1.314，P=0.034)、居住情况(b=–1.995， P=0.012；b=–2.167，P=0.002)、出现HIV感染相关症状(b=4.578，P<0.001；b=3.652，P<0.001)、艾滋病相关压力 (b=0.081，P<0.001；b=0.090，P<0.001)是HIV感染者/AIDS患者抑郁、焦虑情绪的预测因子，社会支持(b=–0.046， P=0.044)是抑郁情绪的预测因子，并且抑郁(ΔR2=55.8%，P<0.001)、焦虑(ΔR2=54.7%，P<0.001)互为强显著预测因子。 结论：在新确认的HIV感染者/AIDS患者中，抑郁、焦虑等情绪问题较为严重，在对该人群进行登记管理的同时应考 虑提供必要的心理社会支持及基本的精神卫生服务。

Emotional problems and related factors in patients with HIV/AIDS

Objective: To investigate the prevalence and related factors of emotional problems of newly identified patients with HIV/AIDS in Changsha, Hunan Province, and to provide scientific evidence for the mental health intervention in this special population. Methods: A total of 370 patients with HIV/AIDS who were newly identified by the Center for Disease Prevention and Control in Changsha City from March 1, 2013 to February 28, 2014 were investigated. Self-designed questionnaire, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HIV/AIDS Stress Scale and Social Support Rating Scale (SSRS) were performed to assess the prevalence of depression, the anxiety symptoms, the HIV related stress and the status of social support. Results: The prevalence of depression and anxiety were 40.3% (PHQ-9≥10 points) and 30.5% (GAD-7≥10 points), respectively. Severe depressive symptoms (PHQ-9≥20 points) and severe anxiety (GAD-7≥15 points) accounted for 8.1% and 14.3%, respectively. Hierarchical regression analysis showed that the status of employment (b=–3.407, P<0.001; b=–2.799, P=0.001), the sexual orientation (b=1.903, P=0.008; b=1.314, P=0.034), the resident status (b=–1.995, P=0.012; b=–2.167, P=0.002), the emergence of HIV-related symptoms(b=4.578, P<0.001; b=3.652, P<0.001) and the HIV related stress (b=0.081, P<0.001; b=0.090, P<0.001) were the predictors for both depressive and anxious emotional problems whereas the social support (b=–0.046, P=0.044) was the predictor for depressive emotional problems. Both anxiety (ΔR2=54.7%, P<0.001) and depression (ΔR2=55.8%, P<0.001) were strong predictors for patients with HIV/AIDS. Conclusion: Depression and anxiety are prevalent among the newly identified patients with HIV/ AIDS. Psychosocial support and basic mental health services should be integrated into the current HIV/AIDS care system.