Impact of antidepressant therapy on cognitive aspects of work, condom use, and psychosocial well-being among HIV clients in Uganda
International Journal of Psychiatry in Medicine
RAND Corporation, 1776 Main St., Santa Monica, CA, United States; Makerere University, Kampala, Uganda
Objective: Depression has been found to impede several health outeomes among people living with HIV, but little research has examined whether depression treatment mitigates this influence. We assessed the impact of antidepressant therapy on measures of work, condom use, and psychosocial well-being among depressed HIV clients in Uganda. Methods: Paired i-tests and McNcmar tests were used to assess change in survey data collected from participants at initiation of antidepressant therapy (baseline) and 6 months later. Results: Ninety-five participants completed the 6-month assessment, of whom 82 (86%) responded to treatment (defined as Patient Health Questionnaire-9 score < 5). Among study completers, work functioning improved significantly, as did measures of self-efficacy related to condom use and work (as well as general self-efficacy), and internalized HIV stigma declined; however, actual engagement in work activity and consistent condom use did not show significant change. Similar findings were observed among treatment responders. Conclusions: Antidepressant treatment benefits functional capacity, psychological well-being, and cognitive intermediary factors that may be essential for behavioral change related to work and condom use, but supplementary therapeutic strategies may be needed to impact more direct behavioral change. © 2014, Baywood Publishing Co., Inc.
antidepressant agent; antidepressant agent; fluoxetine; imipramine; adult; Article; cognition; condom use; depression; female; human; Human immunodeficiency virus infected patient; major clinical study; male; Patient Health Questionnaire 9; psychological well being; self concept; social psychology; stigma; treatment response; Uganda; wellbeing; work; Cognition Disorders; condom; control; Depressive Disorder, Major; developing country; disability; employment; follow up; health behavior; Human immunodeficiency virus infection; middle aged; psychology; quality of life; social stigma; utilization; Adult; Antidepressive Agents; Cognition Disorders; Condoms; Depressive Disorder, Major; Developing Countries; Disability Evaluation; Employment; Female; Fluoxetine; Follow-Up Studies; Health Behavior; HIV Infections; Humans; Imipramine; Internal-External Control; Male; Middle Aged; Quality of Life; Self Efficacy; Social Stigma; Uganda
1R01MH083568, NIMH, National Institute of Mental Health