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Depression Symptom Trajectories Among Mothers Living with HIV in Rural Uganda

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Abstract

The aim was to identify latent class trajectories of depression symptoms among HIV+ women in Uganda. Depression was assessed at four time points using the Hopkins Symptom Checklist among 288 women caring for a child 2–5 years old. Mixture modeling was used to estimate the number and nature of classes defined by trajectories of depressive symptoms over time. Maternal and child characteristics were explored as predictors of class. Three trajectories of symptoms of depression were identified; (1) stable-low, (2) moderate-subclinical, and (3) chronic-high. About 8% of women reported moderately or highly elevated symptoms at the first assessment and consistently onward (i.e. chronically). Higher anxiety levels, less social support, more functionality problems, and more executive behavior problems in children predicted membership in the moderate-subclinical and chronic-high classes. Identifying patterns of depression trajectories can help target intervention efforts for women who are likely to experience the most chronic and impairing symptomatology.

Resumen

El objetivo de este estudio fue identificar trayectorias de síntomas depresivos en mujeres HIV+ en Uganda. Evaluamos síntomas de depresión en 288 mujeres usando el Hopkins Symptom Checklist en cuatro ocasiones. Utilizando modelaje mixto, describimos el número y tipo de clases definidas por las trayectorias de síntomas depresivos a través del tiempo, así como las características de la mujer y un hijo índice asociadas con cada clase. Se identificaron tres trayectorias: (1) estable-leve, (2) moderada-sub clínica y (3) crónica-elevada. Aproximadamente 8% de las mujeres reportaron síntomas depresivos moderados o elevados en todas las evaluaciones (síntomas crónicos). Mayores niveles de ansiedad, menor apoyo social, mayores problemas de funcionamiento y mayores problemas de conducta ejecutiva en niños se asociaron con las clases moderada-sub clínica o crónica-elevada. Identificar patrones y trayectorias de síntomas depresivos sirve para enfocar intervenciones a individuos con mayor probabilidad de experimentar síntomas crónicos e incapacitantes.

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Acknowledgements

We wish to thank the participants and the Global Health Uganda-Tororo team that made this research possible. This research was supported by NIH Grant R01 HD070723. SM was supported by NIMH of the National Institutes of Health under Award Number T32MH10321.

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Authors and Affiliations

  1. Department of Psychiatry, Michigan State University, 909 Fee Rd. A322, East Lansing, MI, USA

    Itziar Familiar & Horacio Ruisenor-Escudero

  2. Departments of Psychiatry and Statistics, Michigan State University, East Lansing, MI, USA

    Alla Sikorskii & Judith Bass

  3. Mental Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Sarah Murray

  4. Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda

    Noeline Nakasujja

  5. College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA

    Clinton Korneffel

  6. Departments of Psychiatry and Neurology, Michigan State University, East Lansing, MI, USA

    Michael Boivin

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  1. Itziar Familiar
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Correspondence to Itziar Familiar.

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Familiar, I., Sikorskii, A., Murray, S. et al. Depression Symptom Trajectories Among Mothers Living with HIV in Rural Uganda. AIDS Behav 23, 3411–3418 (2019). https://doi.org/10.1007/s10461-019-02465-0

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  • DOI: https://doi.org/10.1007/s10461-019-02465-0

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