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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-seven HIV-positive women were recruited in a 2-year prospective investigation into the role of depression in HIV disease progression. All participants had CD4+ cell counts of 200 or less at baseline and at least 3 CD4+ cell counts during follow-up. Participants were evaluated semiannually for CD4+ lymphocyte counts, B2Microglobulin (B2M), hemoglobin data, and new AIDS-defining illnesses. The Center for Epidemiologic Studies Depression Scale was used to assess for depressed mood. Over time, average rates of change in CD4+ counts did not differ significantly between depressed and nondepressed women, even after adjustment for age, antiretroviral use, and baseline CD4 count, and depressed women did not differ from nondepressed women in numbers of new AIDS-defining illnesses. The authors concluded that depression may not be a significant determinant of disease progression in women with advanced disease and called for further investigations with larger samples and women at earlier stages of the infection.
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PMID:Disease progression in HIV-positive women with moderate to severe immunosuppression: the role of depression. Dana Consortium on Therapy for HIV Dementia and Related Cognitive Disorders. 1020 98

This article reviews recent findings concerning the role of psychosocial factors on the progression of HIV. Specifically, we examine the role of depression, stressful life events, social support, and coping on changes in CD4 T-lymphocytes and other indicators of HIV disease progression. Studies have yielded important evidence that depression, stressful life events, low social support, and denial coping may have a detrimental impact on HIV disease course. Delineating the role of psychosocial factors on HIV disease progression may aid in the development of new interventions for this devastating disease.
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PMID:The effects of depression, stressful life events, social support, and coping on the progression of HIV infection. 1112 1

HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period. Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only.
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PMID:HIV adolescents show improved immune function following massage therapy. 1126 7

Advances in antiretroviral therapies for HIV infection have given rise to new hope for the long-term survival of people living with HIV/AIDS. The current study examined changes in depression, anxiety, and HIV treatment attitudes that may co-occur with improvements and setbacks in HIV disease progression in a prospective cohort of 166 HIV-positive men and women. Results from a 9-month prospective observation period showed that persons who experienced increases in viral load, as indexed by medical chart abstraction, reported modest increases in depression and decreases in positive attitudes toward HIV treatments. Persons who experienced substantive decreases in viral load to undetectable levels demonstrated meaningful reductions in depression, particularly affective symptoms of depression after statistically controlling for years living with HIV, HIV symptoms, and age. Results suggest that emotional distress and perceptions of HIV treatments change in parallel to markers of HIV disease progression, especially with regard to reduced emotional distress in response to clinically significant changes in viral load.
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PMID:Prospective study of emotional reactions to changes in HIV viral load. 1194 7

This cohort study examined the impact of phytotherapy (PT; traditional herbs) on neuropsychiatric aspects of HIV disease progression to antibody immunodeficiency syndrome (AIDS), CD4 counts, and viral load in adult patients in Harare, Zimbabwe. This is a community-based and nonintervention cohort study. The study was conducted in and around Harare City from June 1996 to May 1998. One hundred and five volunteers participated in the study. They were seen at the baseline and then followed up on a 3-month basis. The volunteers were interviewed, underwent physical examinations, and had blood drawn for laboratory tests, including the chest X-rays. The outcome measures were: prevalence of mental disorders and depressive symptoms, diagnosis of AIDS, and changes in CD4 cell counts and plasma HIV-I RNA concentrations. Instruments used were the Brief Psychiatric Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), Structured Interview Diagnosis of Dementia According to the DSM-IV (SIDAM), and Centre for Disease Control and Prevention (CDC) criteria as measurement tools. The findings were that patients on the PT had a mean (S.D.) age of 34.5 (7.4) years, whereas those on conventional therapy were a bit older with a mean (S.D.) age of 36.4 (6.6) years, range 19-55 years. The overall prevalence of psychiatric disorders according to the DSM-IV diagnostic criteria at the baseline was 44.8% (n=47, 95% CI=35.3-54.3) and by the end of the 6 months follow-up was 36% (n = 18, 95% CI = 23-49). The relative risks of psychiatric diagnoses were less in patients on PT (P = .046), including the diagnoses of depression (P = .035), than those on conventional therapy. Mean levels of a reported symptom of suicidal thoughts according to the MADRS were lowest in patients on PT than those on conventional therapy (F=5.44, P=.022). Finally, PT is protective against psychiatric disorders in our patients. However, our findings did not support HIV-I disease progression to AIDS in these patients.
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PMID:Neuropsychiatric aspects of HIV disease progression: impact of traditional herbs on adult patients in Zimbabwe. 1199 94

Affective disorders have been reported as the most common mental health problem in persons with HIV infection. Depression has a significant impact on the quality of life of persons living with HIV and AIDS and is associated with HIV disease progression and mortality, even after controlling for sociodemographic and clinical characteristics and substance abuse. Depression has been also reported as one of the main causes of poor adherence with antiretroviral regimens. However, no published investigation has specifically focused on the relationship between depression and adherence to antiretroviral therapy. Nonetheless, information on the association between depressive symptoms and adherence may be gathered from investigations carried out to explore determinants of adherence with antiretroviral therapy. Findings from available studies show a substantial and consistent relationship between adherence to antiretroviral regimens and depression. Early recognition and proper management of depressive comorbidity could be an effective intervention strategy to improve adherence and may make a difference in the quality of life, social functioning, and disease course of people with HIV.
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PMID:Depression is a risk factor for suboptimal adherence to highly active antiretroviral therapy. 1256 37

Can psychological factors, such as depression, affect human immunodeficiency virus progression? HIV infection is viewed as a chronic illness in which those infected often confront a number of emotional challenges and physical health and disease-related issues. Over the past 20 years, there has been increasing evidence that depression and other mood-related disturbances are commonly observed among HIV-positive individuals. There is also mounting data showing that depressive symptoms might further impact upon specific elements of immune system functioning and influence quality of life and health status. This paper will highlight studies examining the prevalence of depression during HIV infection and review some of the evidence examining the impact of depressive symptoms on immune function and HIV disease progression.
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PMID:Depression and HIV infection: impact on immune function and disease progression. 1262 49

Despite the use of laboratory markers in estimating HIV prognosis, significant variation in the natural history of HIV-1 infection remains unexplained. Recent studies suggest psychosocial risk factors have important prognostic significance in HIV disease. The objective of the present study was to examine the prognostic influence of age, general intellectual functioning, and emotional distress across the spectrum of HIV disease progression. The study sample was drawn from the Multicenter AIDS Cohort Study (MACS), a 13-year, prospective study of HIV-seropositive men recruited from four study centers across the country. The participants were 1,231 HIV-seropositive MACS participants, followed from baseline (median 8/15/87) to the end of the observation period (12/15/98). HIV disease progression was evaluated with respect to three outcome measures: (1) number of years from baseline testing to the first AIDS defining illness (progression to AIDS), (2) years from baseline to HIV-dementia (progression to dementia), and (3) years from baseline to death (survival). The influence of psychosocial risk factors on outcome measures was evaluated using survival analyses. General intellectual functioning, age, and somatic symptoms of depression, were found to be significant predictors of HIV disease progression and survival. Older age at baseline was associated with a more rapid progression to dementia and death. Lower Shipley IQ estimates were associated with a more rapid disease progression (AIDS and dementia) and shortened survival. Somatic symptoms of depression were associated with shortened survival. In addition, age, IQ, and somatic symptoms of depression, had an additive effect with an increase in the number of risk factors associated with accelerated disease progression and shortened time to death. These findings remained consistent, despite controlling for baseline CD4 and HIV medication use. Psychosocial cofactors are important in understanding HIV disease progression. Methods for estimating HIV prognosis may become more reliable if psychosocial factors are considered. Future research will clarify if psychosocial risk factors reflect central nervous system integrity, brain reserve capacity or mediate morbidity and mortality through social economic status, access to health care and other social correlates.
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PMID:Psychosocial risk factors of HIV morbidity and mortality: findings from the Multicenter AIDS Cohort Study (MACS). 1281 3

There is much interest in whether depression and stress may explain the wide variability in the disease course of patients infected with human immunodeficiency virus (HIV). This article summarizes the large body of evidence examining whether depression and stress may have an impact on immune- and disease-related parameters in HIV disease. Furthermore, we review what is known about the underlying biological mechanisms of HIV disease, such as alterations in glucocorticoids and catecholamines, which may help explain these psychoimmune relationships. Our review of the literature finds substantial evidence that chronic depression and stressful events may affect HIV disease progression. We know little, however, regarding the biological mechanisms that may account for these relationships. More research is warranted to investigate how depression and stress might impact HIV disease progression and what types of interventions might mitigate the negative impact of chronic depression and trauma.
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PMID:HIV disease progression: depression, stress, and possible mechanisms. 1289 5

A heightened risk of mood disorders, such as major depression, and acute depressive symptoms has been observed among HIV-seropositive individuals since the start of the AIDS epidemic, and an accumulating body of data now shows that depression may have an impact on morbidity and mortality among individuals with HIV disease. Although the specific physiologic mechanisms involved in this process have not been delineated, there is some evidence to suggest that certain components of innate immunity, including killer lymphocytes such as CD8+ T lymphocytes and natural killer cells, may represent key pathways through which depression affects HIV disease progression. This paper reviews some of the main studies examining the effects of depression on immunity and HIV disease progression and discusses the potential role of killer lymphocytes as an underlying mechanism by which depression may impact morbidity and mortality.
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PMID:Association of depression, CD8+ T lymphocytes, and natural killer cell activity: implications for morbidity and mortality in Human immunodeficiency virus disease. 1460 99


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