Abstract
Background: Mental disorder of people living with HIV (PLWH) has become a common and increasing worldwide public health concern. We aimed to explore the relationship between anxiety, depression, and sleep disturbance for PLWH from a network perspective.Methods: The network model featured 28 symptoms on the Hospital Anxiety and Depression scale questionnaire and Pittsburgh Sleep Quality Index questionnaire in a sample of 4,091 HIV-infected persons. Node predictability and strength were computed to assess the importance of items. We estimated and compared 20 different networks based on subpopulations such as males and females to analyze similarities and differences in network structure, connections, and symptoms.Results: Several consistent patterns and interesting differences emerged across subgroups. Pertaining to the connections, some symptoms such as S12–S13 (“sleepy”—“without enthusiasm”) shown a strong positive relationship, indicating that feeling sleepy was a good predictor of lacking enthusiasm, and vice versa. While other symptoms, such as A3–D3 (“worried”—“cheerful”), were negatively related in all networks, revealing that nodes A3 and D3 were bridge symptoms between anxiety and depression. Across all subgroups, the most central symptom was A7 “panic” and S2 “awake”, which had the greatest potential to affect an individual's mental state. While S3 “bathroom” and S5 “cough or snore” shown consistent lower node importance, which would be of limited therapeutic use.Conclusions: Mental conditions of PLWH varied considerably among subgroups, inspiring psychiatrists and clinicians that personalized invention to a particular subgroup was essential and might be more effective during treatment than adopting the same therapeutic schedule.
Highlights
According to the National Health Commission of the People’s Republic of China, there were approximately 958 thousand people living with HIV (PLWH) as of October 2019 [1]
The Hospital Anxiety and Depression (HAD) scale questionnaire consists of seven items on depression (HADD) and anxiety (HAD-A), respectively
40.0% of participants were infected through anal sex, and 57.1% had a current CD4+ T cell count over 350 cells/mm3, and 40.8% were virally suppressed
Summary
According to the National Health Commission of the People’s Republic of China, there were approximately 958 thousand people living with HIV (PLWH) as of October 2019 [1]. Living with HIV implies facing discrimination, perceiving stigma, lacking support, and having sexual problems. This population usually have a high prevalence of mental health problems such as anxiety, depression, sleep disturbance, and autism and so on [3]. The mental disorders are usually related to a wide range of negative outcomes such as decreased quality of life, poor psychosocial functioning, and high drug use [3, 5]. This problem has become a common and increasing worldwide public health concern. We aimed to explore the relationship between anxiety, depression, and sleep disturbance for PLWH from a network perspective
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