This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Tracy J. Mayne, PhD; Eric Vittinghoff, PhD; Margaret A. Chesney, PhD; Donald C. Barrett, PhD; Thomas J. Coates, PhD

Arch Intern Med. 1996;156(19):2233-2238.

Abstract
Background
Although depression has been related to chronic disease processes and outcomes, studies examining the relationship between depression and disease progression in persons with human immunodeficiency virus (HIV) infection have produced inconsistent results.

Objective
To investigate whether depressive affect is associated with HIV mortality.

Methods
This was a prospective cohort study (San Francisco Men's Health Study) using a population-based probability sample of single men living in areas of San Francisco, Calif, with high case rates of acquired immunodeficiency syndrome. Data collection was at 6-month intervals with up to 15 waves of follow-up. Subjects included all 402 homosexual or bisexual men who in July 1984 had serologic evidence of HIV infection and who survived a minimum of 1 wave after baseline. Depressive affect was measured at each wave with the affective subscale of the Center for Epidemiologic Studies— Depression Scale. Laboratory markers, World Health Organization staging, antiretroviral use, and hospitalizations were also used as predictor variables. The primary outcome measure was survival.

Results
In a Cox proportional hazards model, a time-dependent measure of depressive affect was associated with greater mortality (adjusted risk ratio, 1.67; 95% confidence interval, 1.01-2.78).

Conclusions
Depressive affect was associated with mortality risk, highlighting the importance of diagnosis and treatment of depression among HIV-infected gay and bisexual men. Replication of this effect in incident cohorts with well-characterized dates of HIV infection is needed and, if replicated, an exploration of mediating pathways suggested.

Arch Intern Med. 1996;156:2233-2238

Author Affiliations
From the Center for AIDS Prevention Studies (Drs Mayne, Vittinghoff, Chesney, Barrett, and Coates), Division of General Internal Medicine, Department of Medicine (Drs Mayne, Chesney, Barrett, and Coates), and Division of Clinical Epidemiology, Department of Epidemiology (Drs Chesney and Barrett), University of California, San Francisco.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Spiritual Striving, Acceptance Coping, and Depressive Symptoms among Adults Living with HIV/AIDS
Perez et al.
J Health Psychol 2009;14:88-97.
ABSTRACT  

Impact of depression on HIV outcomes in the HAART era
Hartzell et al.
J Antimicrob Chemother 2008;62:246-255.
ABSTRACT | FULL TEXT  

Do Positive Psychosocial Factors Predict Disease Progression in HIV-1? A Review of the Evidence
Ironson and Hayward
Psychosom. Med. 2008;70:546-554.
ABSTRACT | FULL TEXT  

Role of Depression, Stress, and Trauma in HIV Disease Progression
Leserman
Psychosom. Med. 2008;70:539-545.
ABSTRACT | FULL TEXT  

Relation of Lifetime Trauma and Depressive Symptoms to Mortality in HIV
Leserman et al.
Am. J. Psychiatry 2007;164:1707-1713.
ABSTRACT | FULL TEXT  

Effects of Quality of Life and Coping on Depression among Adults Living with HIV/AIDS
Gore-Felton et al.
J Health Psychol 2006;11:711-729.
ABSTRACT  

Psychosocial Factors Predict CD4 and Viral Load Change in Men and Women With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Treatment
Ironson et al.
Psychosom. Med. 2005;67:1013-1021.
ABSTRACT | FULL TEXT  

How Trauma, Recent Stressful Events, and PTSD Affect Functional Health Status and Health Utilization in HIV-Infected Patients in the South
Leserman et al.
Psychosom. Med. 2005;67:500-507.
ABSTRACT | FULL TEXT  

Decreased Depression Up to One Year Following CBSM+ Intervention in Depressed Women with AIDS: The Smart/EST Women's Project
Laperriere et al.
J Health Psychol 2005;10:223-231.
ABSTRACT  

Psychosocial Stress, Personality, and the Severity of Chronic Hepatitis C
Nagano et al.
Psychosomatics 2004;45:100-106.
ABSTRACT | FULL TEXT  

Positive Affect Predicts Lower Risk of AIDS Mortality
Moskowitz
Psychosom. Med. 2003;65:620-626.
ABSTRACT | FULL TEXT  

Psychological Distress is Associated With Decreased Memory Helper T-cell and B-cell Counts in Pre-AIDS HIV Seropositive Men and Women but Only in Those With Low Viral Load
Motivala et al.
Psychosom. Med. 2003;65:627-635.
ABSTRACT | FULL TEXT  

Association of Depression With Viral Load, CD8 T Lymphocytes, and Natural Killer Cells in Women With HIV Infection
Evans et al.
Am. J. Psychiatry 2002;159:1752-1759.
ABSTRACT | FULL TEXT  

Resolved: Psychosocial Interventions Can Improve Clinical Outcomes in Organic Disease--Moderator Introduction
Markovitz
Psychosom. Med. 2002;64:549-551.
FULL TEXT  

Resolved: Psychosocial Interventions Can Improve Clinical Outcomes in Organic Disease (Pro)
Williams and Schneiderman
Psychosom. Med. 2002;64:552-557.
FULL TEXT  

Resolved: Psychosocial Interventions Can Improve Clinical Outcomes in Organic Disease (Con)
Relman and Angell
Psychosom. Med. 2002;64:558-563.
FULL TEXT  

Depressive and Anxiety Disorders in Women With HIV Infection
Morrison et al.
Am. J. Psychiatry 2002;159:789-796.
ABSTRACT | FULL TEXT  

Depression among Patients with HIV/AIDS: A Treatment Dilemma
Overman and Anderson
Journal of Pharmacy Practice 2001;14:540-550.
ABSTRACT  

Challenges Associated With Increased Survival Among Parents Living With HIV
Lee and Rotheram-Borus
AJPH 2001;91:1303-1309.
ABSTRACT | FULL TEXT  

Mortality, CD4 Cell Count Decline, and Depressive Symptoms Among HIV-Seropositive Women: Longitudinal Analysis From the HIV Epidemiology Research Study
Ickovics et al.
JAMA 2001;285:1466-1474.
ABSTRACT | FULL TEXT  

Brief Communication: Detecting Depression: Providing High Quality Primary Care for HIV-Infected Patients
Fairfield et al.
American Journal of Medical Quality 2001;16:71-74.
ABSTRACT  

Cognitive-Behavioral Group Therapy With Medication for Depressed Gay Men With AIDS or Symptomatic HIV Infection
Lee et al.
Psychiatr. Serv. 1999;50:948-952.
ABSTRACT | FULL TEXT  

Stress-Induced Immunomodulation: Implications for Infectious Diseases?
Glaser et al.
JAMA 1999;281:2268-2270.
FULL TEXT  

Progression to AIDS: The Effects of Stress, Depressive Symptoms, and Social Support
Leserman et al.
Psychosom. Med. 1999;61:397-406.
ABSTRACT | FULL TEXT  

Fluoxetine Treatment for Depression in Patients With HIV and AIDS: A Randomized, Placebo-Controlled Trial
Rabkin et al.
Am. J. Psychiatry 1999;156:101-107.
ABSTRACT | FULL TEXT  

Psychological Distress, Coping, and Disease Progression in HIV-positive Homosexual Men
Vassend and Eskild
J Health Psychol 1998;3:243-257.
ABSTRACT  

Depressed Mood and Survival in Seriously Ill Hospitalized Adults
Roach et al.
Arch Intern Med 1998;158:397-404.
ABSTRACT | FULL TEXT