Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH10067
RESEARCH ARTICLE
Contents Vol 8(2)

Changes in depression in a cohort of Danish HIV-positive individuals: time for routine screening

Lotte Rodkjaer A E , Tinne Laursen A , Nils B. Christensen B , Kirsten Lomborg C , Lars Ostergaard A and Morten Sodemann D
+ Author Affiliations
- Author Affiliations

A Department of Infectious Diseases, Aarhus University Hospital, Skejby, DK-8200 Aarhus N., Denmark.

B The Research Clinic for Functional Disorders and Psychosomatic, Aarhus University Hospital, DK-8200 Aarhus N., Denmark.

C Department of Nursing Science, School of Public Health, Aarhus University, DK-8000 Aarhus C., Denmark.

D Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense, Denmark.

E Corresponding author. Email: Lottrodk@rm.dk

Sexual Health 8(2) 214-221 https://doi.org/10.1071/SH10067
Submitted: 9 June 2010  Accepted: 7 September 2010   Published: 18 May 2011

Abstract

Background: The aim of this study was to follow a cohort of HIV-positive individuals for 3 years in order to assess changes in depression, adherence, unsafe sex and emotional strains from living with HIV. Methods: Participants were assessed for depression, adherence, emotional strain and unsafe sex via a questionnaire. The Beck Depression Inventory II (BDI) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above (moderate to major depression) were offered a clinical evaluation by a consultant psychiatrist. Results: In 2005, 205 HIV-positive individuals participated in the study. Symptoms of depression (BDI >14) were observed in 77 (38%) and major depression (BDI ≥20) in 53 (26%) individuals. In 2008, 148 participants were retested (72% of original sample). Depression (BDI >14) was observed in 38 (26%) and symptoms of major depression (BDI ≥20) in 24 (16%) individuals. Patients at risk of moderate to major depression were more likely to be non-adherent to medications, to practice unsafe sex and to suffer from emotional strains compared with patients not at risk of depression, both at baseline (2005) and follow-up (2008). Conclusion: This study demonstrated a decline in depression scores over time and an association between the risk of depression and low medication adherence, stress and unsafe sex. We recommend routine screening for depression to be conducted regularly to provide full evaluations and relevant psychiatric treatment.

Graphical Abstract Image

Additional keywords: adherence, AIDS, compliance, psychiatry, psychological factors, stress.


Acknowledgements

This project was funded by Aarhus University Hospital, Skejby Research Foundation, The Health Insurance Foundation, The Central Denmark Region Health Research Foundation and The Lundbeck Foundation. The authors are grateful to all participants, without whom this work would not have been possible.


References


[1] Rabkin JG. HIV and depression: review and update. Curr HIV/AIDS Rep 2008; 5 163–71.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[2] Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med 2008; 70 539–45.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[3] Bing EG,  Burnam MA,  Longshore D,  Fleishman JA,  Sherbourne CD,  London AS, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry 2001; 58 721–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[4] Ciesla JA,  Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry 2001; 158 725–30.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[5] Leserman J,  Petitto JM,  Gu H,  Gaynes BN,  Barroso J,  Golden RN, et al. Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors. Psychol Med 2002; 32 1059–73.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[6] DiMatteo MR,  Lepper HS,  Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160 2101–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[7] Chander G,  Himelhoch S,  Moore RD. Substance abuse and psychiatric disorders in HIV-positive patients: epidemiology and impact on antiretroviral therapy. Drugs 2006; 66 769–89.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[8] Bouhnik AD,  Préau M,  Vincent E,  Carrieri MP,  Gallais H,  Lepeu G, et al. Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antivir Ther 2005; 10 53–61.
|  CAS | PubMed |

[9] Pence BW,  Miller WC,  Gaynes BN,  Eron JJ. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2007; 44 159–66.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Lima VD,  Geller J,  Bangsberg DR,  Patterson TL,  Daniel M,  Kerr T, et al. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS 2007; 21 1175–83.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Ickovics JR,  Hamburger ME,  Vlahov D,  Schoenbaum EE,  Schuman P,  Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV Epidemiology Research Study. JAMA 2001; 285 1466–74.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[12] Leserman J. HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry 2003; 54 295–306.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Cruess DG,  Evans DL,  Repetto MJ,  Gettes D,  Douglas SD,  Petitto JM. Prevalence, diagnosis, and pharmacological treatment of mood disorders in HIV disease. Biol Psychiatry 2003; 54 307–16.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[14] Alciati A,  Gallo L,  Monforte AD,  Brambilla F,  Mellado C. Major depression-related immunological changes and combination antiretroviral therapy in HIV-seropositive patients. Hum Psychopharmacol 2007; 22 33–40.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Berg CJ,  Michelson SE,  Safren SA. Behavioral aspects of HIV care: adherence, depression, substance use, and HIV-transmission behaviours. Infect Dis Clin North Am 2007; 21 181–200.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] Rodkjaer L,  Laursen T,  Balle N,  Sodemann M. Depression in patients with HIV is under-diagnosed: a cross-sectional study in Denmark. HIV Med 2010; 11 46–53.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[17] Treisman GJ , Angelino AF . The psychiatry of AIDS. A guide to diagnosis and treatment. Baltimore, MD: The John Hopkins University Press; 2004.

[18] Asch SM,  Kilbourne AM,  Gifford AL,  Burnam MA,  Turner B,  Shapiro MF, et al. Under-diagnosis of depression in HIV: who are we missing? J Gen Intern Med 2003; 18 450–60.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[19] Gibbie T,  Mijch A,  Ellen S,  Hoy J,  Hutchison C,  Wright E, et al. Depression and neurocognitive performance in individuals with HIV/AIDS: 2-year follow-up. HIV Med 2006; 7 112–21.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[20] Beck AT,  Ward CH,  Mendelson M,  Mock J,  Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4 561–71.
|  CAS | PubMed |

[21] Lohse N,  Hansen AB,  Jensen-Fangel S,  Kronborg G,  Kvinesdal B,  Pedersen C, et al. Demographics of HIV-1 infection in Denmark: results from the Danish HIV Cohort Study. Scand J Infect Dis 2005; 37 338–43.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Hamilton M. Development of a rating scale; for primary depressive illness. Br J Soc Clin Psychol 1967; 6 278–96.
|  CAS | PubMed |

[23] Dew MA,  Becker JT,  Sanchez J,  Caldararo R,  Lopez OL,  Wess J, et al. Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: a longitudinal evaluation. Psychol Med 1997; 27 395–409.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[24] Atkinson JH,  Grant I. Natural history of neuropsychiatric manifestations of HIV disease. Psychiatr Clin North Am 1994; 17 17–33.
|  CAS | PubMed |

[25] Olfson M,  Marcus SC,  Tedeschi M,  Wan GJ. Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry 2006; 163 101–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[26] Blalock AC,  McDaniel JS,  Farber EW. Effect of employment on quality of life and psychological functioning in patients with HIV/AIDS. Psychosomatics 2002; 43 400–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[27] Dray-Spira R,  Gueguen A,  Lert F,  VESPA Study Group Disease severity, self-reported experience of workplace discrimination and employment loss during the course of chronic HIV disease: differences according to gender and education. Occup Environ Med 2008; 65 112–9.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[28] Scott-Sheldon LA,  Kalichman SC,  Carey MP,  Fielder RL. Stress management interventions for HIV+ adults: a meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychol 2008; 27 129–39.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[29] Ironson G,  O’Cleirigh C,  Fletcher MA,  Laurenceau JP,  Balbin E,  Klimas N, et al. Psychosocial factors predict CD4 and viral load change in men and women with human immunodeficiency virus in the era of highly active antiretroviral treatment. Psychosom Med 2005; 67 1013–21.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[30] Carrico AW,  Antonia MH. Effects of psychological interventions on neuroendocrine hormone regulation and immune status in HIV-positive persons: a review of randomized controlled trials. Psychosom Med 2008; 70 575–84.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[31] Pyne JM,  Asch SM,  Lincourt K,  Kilbourne AM,  Bowman C,  Atkinson H, et al. Quality indicators for depression care in HIV patients. AIDS Care 2008; 20 1075–83.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[32] Starace F,  Ammassari A,  Trotta MP,  Murri R,  De Longis P,  Izzo C, et al. NeuroICoNA Study Group. Depression is a risk factor for suboptimal adherence to highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2002; 31 S136–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[33] Yun LW,  Maravi M,  Kobayashi JS,  Barton PL,  Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr 2005; 38 432–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |