Evaluation of depression, anxiety and insomnia in people living with HIV/AIDS in India

Abstract

Introduction: Mental disorders are quite common in association with human immunodeficiency virus (HIV). Mental disorders are more prevalent in people living with HIV/AIDS (PLWHA) than the general population. The aim of this study was to evaluate depression, anxiety and insomnia in PLWHA and its correlation with socio-demographic factors and cluster of differentiation-4 (CD4) count. Material and methods: This was a cross sectional study conducted in Pt. BD Sharma PGIMS, Rohtak on 500 PLWHA in India. Hospital Anxiety and Depression Scale-Depression (HADS-D), Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Pittsburgh Sleep Quality Index (PSQI) scale were used to assess depression, anxiety and insomnia respectively in PLWHA. Five groups were designed on the basis of CD4 count: Group A (< 100 cells/μl), Group B (100-199 cells/μl), Group C (200-349 cells/μl), Group D (350-499 cells/μl) and Group E (> 500 cells/μl). Results: Prevalence of anxiety, depression and insomnia was found to be 59.6%, 61.2% and 56.4% respectively. Males had higher prevalence of depression and insomnia which are 64.2% and 57.4% respectively, whereas female had higher prevalence of anxiety (63%). There was a positive correlation between each score i.e. HADS-A, HADS-D and PSQI scale. There was a weak negative correlation between CD4 and each score. Conclusions: Despite higher prevalence, psychiatric illnesses remains underdiagnosed most of the time. Thus clinicians at the anti-retroviral therapy centre should screen these patients for depression, anxiety and depression for improvement in morbidity and mortality in PLWHA.