TY - JOUR
T1 - Effectiveness of depression interventions for people living with HIV in Sub-Saharan Africa
T2 - A systematic review & meta-analysis of psychological & immunological outcomes
AU - Passchier, Ruth Verity
AU - Abas, Melanie Amna
AU - Ebuenyi, Ikenna D.
AU - Pariante, Carmine M.
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2018/10
Y1 - 2018/10
N2 - This meta-analytic review evaluated the effectiveness of depression interventions on the psychological and immunological outcomes of people living with HIV in sub-Saharan Africa. 14 studies, yielding 932 participants were eligible. A random-effects models indicated that depression interventions were followed by large reductions in depression scores (effect size = 1.86, 95% CI = 1.71, 2.01, p < 0.01). No significant effect on immune outcome was observed, however there was a trend toward immune improvement of medium effect size (effect size on CD4 count and/or viral suppression = 0.57, 95% CI = −0.06, 1.20, p = 0.08). Pharmacological interventions appeared to have a significantly larger improvement in depression scores than psychological interventions. The greatest improvement in immune status was demonstrated in psychological treatments which incorporated a component to enhance HIV medication adherence, however these results did not reach significance. Small sample sizes and highly heterogeneous analysis necessitate caution in interpretation. The results of this meta-analysis should thus be treated as preliminary evidence and used to encourage further studies of immunopsychiatry in HIV in sub-Saharan Africa.
AB - This meta-analytic review evaluated the effectiveness of depression interventions on the psychological and immunological outcomes of people living with HIV in sub-Saharan Africa. 14 studies, yielding 932 participants were eligible. A random-effects models indicated that depression interventions were followed by large reductions in depression scores (effect size = 1.86, 95% CI = 1.71, 2.01, p < 0.01). No significant effect on immune outcome was observed, however there was a trend toward immune improvement of medium effect size (effect size on CD4 count and/or viral suppression = 0.57, 95% CI = −0.06, 1.20, p = 0.08). Pharmacological interventions appeared to have a significantly larger improvement in depression scores than psychological interventions. The greatest improvement in immune status was demonstrated in psychological treatments which incorporated a component to enhance HIV medication adherence, however these results did not reach significance. Small sample sizes and highly heterogeneous analysis necessitate caution in interpretation. The results of this meta-analysis should thus be treated as preliminary evidence and used to encourage further studies of immunopsychiatry in HIV in sub-Saharan Africa.
KW - CD4
KW - Depression
KW - HIV/AIDS
KW - Immunopsychiatry
KW - Intervention
KW - Meta-analysis
KW - Psychoneuroimmunology
KW - Review
KW - Sub-Saharan Africa
KW - Viral load
UR - http://www.scopus.com/inward/record.url?scp=85047360876&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047360876&partnerID=8YFLogxK
U2 - 10.1016/j.bbi.2018.05.010
DO - 10.1016/j.bbi.2018.05.010
M3 - Article
C2 - 29768184
VL - 73
SP - 261
EP - 273
JO - Brain Behavior and Immunity
JF - Brain Behavior and Immunity
SN - 0889-1591
ER -