Prevalence of depressive symptoms and associated factors among people who inject drugs in China

Abstract

Background: People who inject drugs (PWID) have a high prevalence of mental health problems (e.g., depression) which compromise the effects of HIV prevention. We investigated the prevalence of depression and associated factors among PWID in Dazhou, China.

Methods: Anonymous face-to-face interviews were administered to eligible participants by well-trained doctors. The Center of Epidemiological Studies Depression Scale (CES-D) was used to measure depression, using hierarchical linear regression models.

Results: Among the 257 participants, 7.0%, 11.3%, and 75.1% were probable cases of mild (16 ≤ CES-D < 21), moderate (21 ≤ CES-D < 25), and severe (CES-D ≥ 25) depression, respectively. Hopefulness (standardized β = -0.34, p < 0.001) and emotional family support (β = -0.21, p < 0.001) were negatively associated, whereas severity of drug dependence (β = 0.12, p = 0.034) and unmet service needs (β = 0.20, p < 0.001) were positively associated, respectively, with CES-D scores. The adjusted analysis showed that resilience was negatively associated with CES-D, but it was not selected by the stepwise model containing hopefulness and emotional family support. Protective factors (i.e., hopefulness and emotional family support) and risk factors (i.e., severity of drug dependence and unmet service needs) remained significant in the same regression model.

Conclusion: Protective and risk factors were independently associated with depressive symptoms. Integrated interventions covering basic and psychosocial needs for PWID are warranted. Such interventions should strengthen emotional family support and cultivate positive factors such as hopefulness.

Keywords: Depression; Family support; Hopefulness; People who inject drugs; Resilience; Unmet service needs.