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J Affect Disord. 2008 Jun;108(3):225-34. Epub 2007 Nov 28.

Two-year prospective study of major depressive disorder in HIV-infected men.

Author information

1
Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, California 92093, USA. jhatkinson@ucsd.edu

Abstract

OBJECTIVE:

The risks and factors contributing to major depressive episodes in HIV infection remain unclear. This 2-year prospective study compared cumulative rates and predictors of a major depressive episode in HIV-infected (HIV+) men (N=297) and uninfected (HIV-) risk-group controls (N=90).

METHODS:

By design participants at entry were without current major depression, substance dependence or major anxiety disorder. Standardized neuromedical, neuropsychological, neuroimaging, life events, and psychiatric assessments (Structured Clinical Interview for DSM III-R) were conducted semi-annually for those with AIDS, and annually for all others.

RESULTS:

Lifetime prevalence of major depression or other psychiatric disorder did not differ at baseline between HIV+ men and controls. On a two-year follow-up those with symptomatic HIV disease were significantly more likely to experience a major depressive episode than were asymptomatic HIV+ individuals and HIV-controls (p<0.05). Episodes were as likely to be first onset as recurrent depression. After baseline disease stage and medical variables associated with HIV infection were controlled, a lifetime history of major depression, or of lifetime psychiatric comorbidity (two or more psychiatric disorders), predicted subsequent major depressive episode (p<0.05). Neither HIV disease progression during follow-up, nor the baseline presence of neurocognitive impairment, clinical brain imaging abnormality, or marked life adversity predicted a later major depressive episode.

LIMITATIONS:

Research cohort of men examined before era of widespread use of advanced anti-HIV therapies.

CONCLUSIONS:

Symptomatic HIV disease, but not HIV infection itself, increases intermediate-term risk of major depression. Prior psychiatric history most strongly predicted future vulnerability.

PMID:
18045694
PMCID:
PMC2494949
DOI:
10.1016/j.jad.2007.10.017
[Indexed for MEDLINE]
Free PMC Article

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