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Major Depressive Disorder Among HIV Infected Youth in Uganda: Incidence, Persistence and Their Predictors

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Abstract

Incidence and persistence of major depressive disorder (MDD) in children and adolescents with HIV (CA-HIV) in Uganda is described. 1339 CA-HIV attending care were enrolled and followed up for 12 months. MDD was assessed using the DSM-5 referenced Child and Adolescent Symptom Inventory-5 (CASI-5), with a prevalence for MDD at baseline of 5% (95% CI 3.3–7.3). Kaplan-Meir method was used to estimate incidence of MDD and Cox models were fitted to investigate predictors of incident MDD. Cumulative incidence of MDD over 12 months was 7.6 per 100 person-years 95% CI (6.2–9.4) and a rate of persistent MDD of 10/105 (9.5% CI 3.9–15.1). Significant independent predictors of incident MDD were: highest educational level of CA-HIV (protective), increasing depressive scores and decreasing CD4 Nadir. These finding have implications for what should constitute components of a mental health integration model in HIV youth services and for the future development of individualised mental health care.

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Acknowledgement

We would like to acknowledge the work and support provided by the staff of the Mental Health Section at the MRC/UVRI & LSHTM Uganda Research Unit. We would also like to acknowledge the support and corporation of children/adolescents, caregivers and management of The AIDS Support Organisation (TASO) clinic (Masaka), Kitovu Mobile AIDS organisation (Masaka), The Uganda Cares clinic (Masaka), Joint Clinical Research Centre clinic (Kampala) and Nsambya Home care Department (Kampala). This work was supported by a Medical Research Council / Department for International Development- African Leadership Award to Eugene Kinyanda, Number MR/L004623/1.

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Authors and Affiliations

  1. MRC/UVRI & LSHTM Uganda Research Unit / Senior Wellcome Trust Fellowship, Mental Health Section, P.O. Box 49, Entebbe, Uganda

    Eugene Kinyanda, Sylvia Kiwuwa Muyingo, Wilber Ssembajjwe & Richard S. Mpango

  2. Department of Psychiatry, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda

    Eugene Kinyanda, Noeline Nakasujja, Catherine Abbo & Seggane Musisi

  3. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AF, UK

    Tatiana T. Salisbury & Ricardo Araya

  4. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Private Bag 3, Wits, 2050, South Africa

    Jonathan Levin

  5. Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa

    Soraya Seedat

  6. Department of Psychiatry, Stony Brook University, 01 Nicolls Rd, Stony Brook, NY, 11794, USA

    Kenneth D. Gadow

  7. Department of Global Health and Social Medicine, Harvard Medical School, A-111, 25 Shattuck St, Boston, MA, 02115, USA

    Vikram Patel

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  1. Eugene Kinyanda
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  2. Tatiana T. Salisbury
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  3. Sylvia Kiwuwa Muyingo
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  4. Wilber Ssembajjwe
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  5. Jonathan Levin
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  7. Richard S. Mpango
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  9. Soraya Seedat
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  11. Seggane Musisi
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  12. Kenneth D. Gadow
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  13. Vikram Patel
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Correspondence to Eugene Kinyanda.

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Prof Kenneth D Gadow who is a co-author of this manuscript is one of the developers of the Child and Adolescent Symptom Inventory-5 (CASI-5), the psychiatric assessment instrument used in this study.

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Kinyanda, E., Salisbury, T.T., Muyingo, S.K. et al. Major Depressive Disorder Among HIV Infected Youth in Uganda: Incidence, Persistence and Their Predictors. AIDS Behav 24, 2588–2596 (2020). https://doi.org/10.1007/s10461-020-02815-3

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