Monday, November 3, 2003

This presentation is part of : Lipodystrophic Symptomatology, Medication Adherence, Depression, CAM Therapies, and Health-Related Quality of Life in Persons with HIV Disease

Relationship between lipodystrophy-associated morphologic/metabolic changes and depression in persons infected with HIV/AIDS

Jeanne Kemppainen, RN, PhD, CNS1, Kenn M. Kirksey, RN, PhD, APRN, BC2, Patrice Kenneally Nicholas, RN, DNSc, MPH, ANP3, Inge B. Corless, RN, PhD, FAAN3, and Margaret E. Mueller, RN, MSN4. (1) School of Nursing, The University of North Carolina at Wilmington, Wilmington, NC, USA, (2) Department of Nursing, California State University, Fresno, Fresno, CA, USA, (3) Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA, (4) Department of Nursing, Veteran's Administration Healthcare System/CSU Fresno, Fresno, CA, USA

Symptoms serve as intervention foci for individuals and healthcare providers. Previous research demonstrates that there is an association between the symptom experience and depression in persons with HIV/AIDS. Objective: This paper reports on the relationship between lipodystrophy-related symptom experiences and depression in persons with HIV disease. Design: A cross-sectional, descriptive design was used. Population, Sample, Setting: Data were obtained from outpatients in three HIV/AIDS clinics in California, Massachusetts, and Texas. The sample was comprised of 64 Caucasians, 51 African-Americans, 44 Hispanics, and 6 others, ranging in age from 21-62 years with a mean age of 42.12 (SD + 8.29). Variables: The variables for this study included depression, body fat and metabolic changes associated with self-reported, HIV-related lipodystrophy symptoms. Methods: The Centers for Epidemiological Studies Depression Scale (CES-D) was used to measure depression and four researcher-generated open-ended questions were utilized to obtain data on presence and frequencies of symptoms, management strategies and client ‘feelings’ related to the physical changes. Findings: The mean CES-D (depression) score was 28.96 (SD + 11.62). Scores > 16 on this Likert-type scale are diagnostic for clinical depression. In contrast, the mean score on a single item on the sociodemographic data sheet that asked participants to rank their psychological support on a scale of 1-10 with “1” being “very poor” and “10” being “excellent,” was 6.96 (SD + 2.60). The majority of the sample reported having a number of lipodystrophy-associated symptoms. Approximately 67% of the sample also indicated having one or more comorbidities. Conclusions: Subjects’ responses indicated clinical depression, possibly associated with significant numbers of HIV-associated lipodystrophy symptoms, but they reported moderately high levels of psychological support from significant others. Implications: Randomized clinical trials are indicated to explore better ways of intervening in persons with depression and the presence or absence of other comorbidities (e.g., lipodystrophy, depression).

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