Latent Class Analysis On The Depressive Symptoms Among People Living With HIV/AIDS

Objectives:The aims of this study were to investigate the individual differences in depression symptoms among people living with HIV/AIDS,to explore their latent categories of depressive symptoms,and to analyze the psychological characteristics,overall health status,and quality of life among different categories of depressive symptoms.Methods:This study was a cross-sectional study.The questionnaire survey was conducted among people living with HIV/AIDS attending to a certain infectious disease hospital in Shandong Province from April 2017 to December 2017.A total of 189 valid questionnaires were retrieved,and the response rate was 82.53%.The questionnaire forms included general data questionnaires,Patient Health Questionnaire-9,Generalized Anxiety Scales-7,the Perceived Stress Scale,Ruminative Responses Scale,Rosenberg Self-Esteem Scale,10-item Connor-Davidson Resilience Scale,EORTC Quality of Life Questionnaire Core,and the Pittsburgh Sleep Quality Index.Latent class analysis was used to explore the potential categories of depressive symptoms among people living with HIV/AIDS,and analyze the distribution of latent categories of depressive symptoms.Chi-square tests and analysis of variance were used to analyze the difference among different categories.The psychological characteristics,overall health status,quality of life,and quality of sleep among different categories of depression symptoms were also compared.Results:(1)Depressive symptoms were found in 68.2%of people living with HIV/AIDS,with severe depression accounting for 5.3%,moderate-to-severity for 13.2%,moderate depression for 16.9%,and mild depression for 32.8%.(2)The latent class analysis indicated that depressive symptoms could be classified into four categories:"Major Depression"(Category 4),"Emotional Depression"(Category 3),"Physiological Depression"(Category 2),and "None Depression"(Category 1).(3)There was a significant difference among different class of depressive symptoms in the average monthly household(P=0.025).The percentage of people with monthly income ? 4000 Chinese yuan in Category 1 was 57.5%,which was higher than the other three categories.There was no statistically difference among different class in other demographic data(p>0.05).(4)There were significant differences among different class of depressive symptoms in the course of disease and antiviral treatment time(P was 0.018 and 0.005,respectively).The course of disease and antiviral treatment time of Category 1 and Category 4 were significantly longer than those of Category 2 and Category 3,respectively.(5)The analysis of variance indicated there were significant differences among different class of depressive symptoms in stress,anxiety,rumination,self-esteem,and psychological resilience(P<0.05).Category 4 had the highest scores in stress,anxiety,rumination,and all dimensions of rumination,and self-esteem and psychological resilience scores were the lowest.Category 1 had the lowest scores in stress,anxiety,rumination,and all dimensions of rumination,with the highest scores in psychological resilience.(6)There were significant differences among different class of depressive symptoms in overall health status,quality of life,and sleep quality(P<0.05).The post-hoc analysis showed that Category 4 had the worst overall quality of life,while Category 1 had the best overall health status and quality of life.Conclusions:(1)Depressive symptoms are prevalent among people living with HIV/AIDS and need more attention.(2)The depressive symptoms of people living with HIV/AIDS have obvious classification characteristics.A model containing 4 potential categories is established.They are named Category 4 "Major Depression",Category 3 "Emotional Depression",Category 2 "Physical Depression",and Category 1 "No Depression".(3)The psychological characteristics,overall health status,quality of life,and sleep quality are different among different categories of depressive symptoms.Category 4 has the highest level of depression,highest scores in stress,anxiety,rumination,and all dimensions of rumination,and lowest self-esteem and psychological resilience scores.The overall quality of life of Category 4 is the worst.Category 1 had the lowest level of depression,the lowest scores for stress,anxiety,rumination,and all dimensions of rumination,and the highest score for psychological resilience.The overall health status and overall quality of life of Category 1 were the best among 4 categories.(4)Personalized interventions for people living with HIV/AIDS with different categories of depressive symptoms will be beneficial to reduce depressive symptoms,improve their quality of life and adherence to treatment.