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Evaluation of Psychosocial Problems Among African University Students in Uganda： Development and Validation of a Screening Instrument

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Psychology Research 2014年第2期4卷 112-131页

作者： Norman David Nsereko seggane musisi Steven Holtzman Nkumba University Entebbe Uganda Makerere University Kampala Uganda Center for Data Analysis ResearchEducational Testing Service Princeton USA

Establishing the nature of psychosocial problems for effective intervention through quantitative assessment by university counselors in Uganda is impeded for lack of instruments that are developed or validated in their own environments or they are too costly on the market. This has left many vulnerable university students and the university mental health very much compromised. The aim of the study was to develop a psychometrically sound psychosocial instrument that could be used to identify psychosocial problems among university students for professional intervention. An exploratory, cross-sectional study employing random sampling technique with both qualitative and quantitative approaches was used in the development and validation of the instrument. Respondents from university students and key informants were involved. The resulting 17-item USEPP (University Students Evaluation of Psychosocial Problems) was interpreted as a four dimensional measure of psychosocial problems namely, emotional, concerns, trauma experiences, antisocial behavior, and academic concerns among university students. USEPP cut off point was established at 18 and it reported sensitivity at 99.1% (95% CI = 95-100), specificity at 98.03% (95% CI = 96-99) p < 0.0001, +PV = 95, -PV = 96. AUC (area under curve) = 0.997. It has an internal consistency of 0.81. It was validated with HSCL-10 a psychological distress instrument. The validation indicated that USEPP measures psychosocial factors, it discriminates university students with or without psychosocial problems and that it can predict psychological distress. USEPP may be used to screen for psychosocial problems among university students for early intervention and for research purposes.

关键词：心理问题社会行为大学生乌干达验证筛选非洲评估

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Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

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Health 2012年第12期4卷 1334-1345页

作者： Ruth M. Senyonyi Lee A. Underwood Elisabeth Suarez seggane musisi Todd L. Grande College of Social and Behavioral Sciences Wilmington University New Castle USA Department of Psychiatry Makerere University Kampala Uganda Regent University School of Psychology & Counseling Virginia Beach USA

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

关键词： Group Counseling Cognitive Behavioral Therapy HIV/AIDS Adolescents Perinatally Infected

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Depression and Its Relationship to Work Status and Income among HIV Clients in Uganda

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World Journal of AIDS 2012年第3期2卷 126-134页

作者： Glenn J. Wagner Bonnie Ghosh-Dastidar Dickens Akena Noeline Nakasujja Elialilia Okello Emmanuel Luyirika seggane musisi Department of Psychiatry College of Health Sciences Makerere University Kampala Uganda Mengo Hospital Kampala Uganda RAND Corporation Santa Monica USA

Purpose: Despite high levels of depression among persons living with HIV (PLWHIV), little research has investigated the relationship of depression to work status and income in PLWHIV in sub-Saharan Africa, which was the focus of this analysis. Methods: Baseline data from a prospective longitudinal cohort of 798 HIV patients starting antiretroviral therapy in Kampala, Uganda were examined. In separate multivariate analyses, we examined whether depressive severity and symptom type [as measured by the Patient Health Questionnaire (PHQ-9)] and major depression [diagnosed with the Mini International Neuropsychiatric Interview (MINI)] were associated with work status and income, controlling for demographics, physical health functioning, work self-efficacy, social support and internalized HIV stigma. Results: 14% of the sample had Major Depression and 66% were currently working. Each measure of depression (PHQ-9 total score, somatic and cognitive subscales;Major Depression diagnosis) was associated with not working and lower average weekly income in bivariate analysis. However, none of the depression measures remained associated with work and income in multivariate analyses that controlled for other variables associated with these economic outcomes. Conclusions: These findings suggest that while depression is related to work and income, its influence may only be indirect through its relationship to other factors such as work self-efficacy and physical health functioning.

关键词： Depression HIV/AIDS Work Income Physical Health Functioning Work Self-Efficacy

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Depression, Internalized HIV Stigma and HIV Disclosure

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World Journal of AIDS 2015年第1期5卷 30-40页

作者： Elialilia S. Okello Glenn J. Wagner Bonnie Ghosh-Dastidar Jeffrey Garnett Dickens Akena Noeline Nakasujja seggane musisi Department of Psychiatry Makerere University College of Health Sciences Kampala Uganda RAND Corporation Santa Monica USA

Purpose: There is extensive evidence regarding the relationship between HIV related stigma and disclosure;however, the influence of depression in this relationship is not well understood, and thus is the focus of our analysis. Methods: Baseline data from a prospective longitudinal cohort of 798 HIV patients starting ART in Kampala, Uganda were examined. A staged-approach regression analysis was used to examine variables associated with HIV disclosure to most people (general disclosure) and disclosure to primary sex partner. Internalized HIV stigma plus demographic and background covariates were first entered into the model;the binary indicator of clinical depression was added on step two, followed by the addition of the interaction of stigma and depression in step three. Separate analyses were conducted for each of the two disclosure outcomes. Results: 39% indicated that they kept their HIV status as a secret from most people, while 19% of respondents with a regular sex partner had not disclosed their HIV status to the partner. In bivariate analysis, respondents who preferred to keep their HIV status as a secret from most people had higher internalized HIV stigma (p < 0.001) and depression (p < 0.01), and were more likely to be clinically depressed (p < 0.01) compared with others in the sample. Similarly, participants who had not disclosed their HIV status to their main sex partner had higher internalized HIV stigma (p < 0.01) and depression (p < 0.05), and were more likely to be clinically depressed (p < 0.01) compared with those who had informed their partner of their HIV status. The regression analysis revealed that internalized HIV stigma was strongly negatively correlated with disclosure to primary partner, while depression was not associated. In the regression analysis for general disclosure, both stigma and depression were negatively correlated with disclosure when the interaction term was included in the model. Further analysis showed that internalized HIV s

关键词： Depression Internalized HIV Stigma HIV Disclosure

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Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda

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World Journal of AIDS 2022年第2期12卷 43-54页

作者： Lilian Bulage Benedict Akimana Justine D. Namuli seggane musisi Josephine Birungi Micheal Etukoit Ramin Mojtabai Jean B. Nachega Edward J. Mills Etheldreda Nakimuli-Mpungu African Field Epidemiology Network Kampala Uganda Uganda Public Health Fellowship Program Kampala Uganda Ministry of Health Butabika National Referral Mental Hospital Kampala Uganda Department of Psychiatry College of Health Sciences Makerere University Kampala Uganda The AIDS Support Organization (TASO) Kampala Uganda Department of Mental Health Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Departments of Epidemiology Infectious Diseases and Microbiology Graduate School of Public Health University of Pittsburgh Pittsburgh USA Center for Infectious Disease Department of Medicine Faculty of Medicine and Health Sciences Stellenbosch University Cape Town South Africa Departments of International Health and Epidemiology Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton Canada

Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder;we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.

关键词： Depression Suicide Risk Anti-Retroviral Therapy Viral Suppression Uganda

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USPPDT （University Student Psychosocial Problems Development Theory）

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Psychology Research 2014年第4期4卷 259-264页

作者： Norman David Nsereko seggane musisi Nkumba University Entebbe Uganda Makerere University Kampala Uganda

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