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

There is a high incidence of life event stress, depression, and associated symptoms in individuals with HIV infection/AIDS. Psychological and psychiatric symptomatology in individuals with HIV and AIDS may be related to the progression of AIDS disease. The association between depression, anxiety, and stress with HIV disease progression suggests that neurobiologic and neurophysiologic factors have an important role in modulating HIV. The immune effects caused by changes in behavioral state or brain activity are affected, at least in part, through the neuroendocrine-immune pathways. Life stress and depression may be associated with altered blood levels of CNS-released neuropeptides, including substance P (SP). SP is a powerful immunomodulator which is a critical link between the nervous and immune system. We have investigated the role of the neuropeptide SP and its preferred receptor, neurokinin-1, in HIV infection and AIDS. There are compelling data from our laboratories, as well as the findings in the literature, which demonstrate that SP may play an important role in the pathophysiology of neuropsychiatric disorders, including stress and depression in HIV-infected individuals and in the immunopathogenesis of HIV disease. Modulation of SP activity and SP receptor may offer a novel approach to the treatment of psychiatric disorders and to the design of new anti-HIV therapy.
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PMID:Substance P and neurokinin-1 receptor modulation of HIV. 1557 79

Recent research suggests that the presence of posttraumatic stress disorder (PTSD) and depressive symptoms is independently related to abnormal hormone levels, inadequate medication adherence, and faster HIV disease progression. Although PTSD and depression occur comorbidly at high rates, the impact of both disorders on adherence and disease progression has not been examined. The present study examined the impact of PTSD and comorbid depression on CD4 cell counts and medication adherence in 58 male and 11 female (36% African American) HIV-positive individuals recruited from an AIDS service organization. Results revealed that participants high in depressive symptoms had lower CD4 cell counts and were less likely to adhere to their medication regimens than participants high in PTSD symptoms and those high in comorbid symptomatology. The present results suggest that the presence of depressive symptoms may be responsible for the observed impact of PTSD on people living with HIV (PLWH), and that failure to examine comorbid disorders may not adequately address the impact of clinical symptoms on people living with HIV.
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PMID:Incidence and impact of posttraumatic stress disorder and comorbid depression on adherence to HAART and CD4+ counts in people living with HIV. 1628 33

In HIV-infected adults, psychiatric disorders result in poor quality of life, HIV disease progression, poor compliance and increased mortality. The same may be true for children and adolescents challenged with HIV/AIDS. The literature regarding the prevalence of Diagnostic and Statistical Manual of the American Psychiatric Association (DSM) psychiatric disorders in pediatric patients with HIV/AIDS was reviewed. Of over 500 papers reviewed only eight attempted to quantify prevalence in some way. Average prevalences of 28.6% for attention deficit hyperactivity disorder, 24.3% for anxiety disorders and 25% for depression were found with respective risk ratios of 6.0, 3.8 and 7.1. However, sample sizes were small and only two of the eight studies were controlled. Surprisingly little has been done to describe and quantify what mental-health problems these HIV-positive children and adolescents face.
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PMID:DSM psychiatric disorders in the context of pediatric HIV/AIDS. 1677 35

The effect of depression on HIV disease progression was examined among 996 HIV-positive Tanzanian women participating in a trial on micronutrients and pregnancy outcomes, vertical transmission, and disease progression. Depression and social support were measured 2 months after HIV screening and every 6 to 12 months thereafter. Depression measures from pregnancy and more than 12 months postpartum were included in this analysis. Participants' clinical condition and access to supportive individual or group counseling was assessed throughout the 6 to 8 years of follow-up. Cox proportional hazard models were used to estimate the time-varying effect of depression on progression to HIV clinical stage III/IV (World Health Organization) and all-cause mortality. Participation in group or individual counseling and baseline social support were also examined. More than half (57%) of the study sample had symptoms comparable with depression at least once during the follow-up period. Controlling for sociodemographic variables, psychosocial support, and clinical condition at enrollment, depression was associated with an increased risk of disease progression (HIV clinical stage III/IV [hazard ratio (HR) = 1.61, 95% confidence interval (CI): 1.28 to 2.03] and mortality [HR = 2.65, 95% CI: 1.89 to 3.71]). Depression is common among HIV-infected Tanzanian women and increases the risk of disease progression. Screening for depression and providing psychosocial interventions should be considered part of comprehensive HIV care.
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PMID:Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. 1717 66

The use of highly active antiretroviral therapy (HAART) has resulted in dramatic reductions in morbidity and mortality of HIV infected individuals. With increasing life expectancy, a growing population of women will experience menopausal transitions while infected with HIV. Changes associated with menopause may affect HIV disease progression, and HIV-infected women may experience menopause in a different way from that of uninfected women. Age at natural menopause among non-HIV-infected white and Hispanic women is on the average 51 years, and that of African American women is 49 years. Several studies have shown that the mean age of menopause in HIV-infected women is 47-48 years. This is likely due to factors other than HIV infection that predict early menopause, such as drug use, smoking, and low socioeconomic status. It may be difficult to separate out HIV symptoms from menopausal symptoms. The additive effects of menopause, HIV infection, and HAART on changes involving bone, lipid, and glucose metabolism need further investigation. Likewise, there is a need for a better understanding of the prevalence and manifestations of depression among these women.
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PMID:HIV and menopause: a review. 1806 55

Lower smoking cessation rates are associated with body image concerns in the general population. This relationship is particularly important to study in individuals living with HIV/AIDS due to alarmingly high smoking rates and considerable bodily changes experienced with HIV disease progression and treatment. The association between body image and smoking cessation rates was examined among individuals living with HIV/AIDS participating in a smoking cessation intervention. Body image concerns were significantly associated with depression, anxiety, stress, and social support, all variables known to affect cessation rates. However, reduced quit rates were found among individuals reporting elevated and low levels of body image concerns at the end of treatment. These findings suggest a unique relationship between smoking and body image among individuals living with HIV/AIDS. Further research is needed to examine these effects and whether moderate levels of body image concerns in this population reflect realistic body perceptions associated with positive mental health.
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PMID:The association between body image and smoking cessation among individuals living with HIV/AIDS. 1808 65

Despite advances in HIV treatment, there continues to be great variability in the progression of this disease. This paper reviews the evidence that depression, stressful life events, and trauma account for some of the variation in HIV disease course. Longitudinal studies both before and after the advent of highly active antiretroviral therapies (HAART) are reviewed. To ensure a complete review, PubMed was searched for all English language articles from January 1990 to July 2007. We found substantial and consistent evidence that chronic depression, stressful events, and trauma may negatively affect HIV disease progression in terms of decreases in CD4 T lymphocytes, increases in viral load, and greater risk for clinical decline and mortality. More research is warranted to investigate biological and behavioral mediators of these psychoimmune relationships, and the types of interventions that might mitigate the negative health impact of chronic depression and trauma. Given the high rates of depression and past trauma in persons living with HIV/AIDS, it is important for healthcare providers to address these problems as part of standard HIV care.
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PMID:Role of depression, stress, and trauma in HIV disease progression. 1851 80

The psychological and physical demands of coping with medication side effects and comorbid illnesses can be overwhelming and may influence behaviors, such as medication adherence, substance use, sexual risk behavior, and exercise that, in turn, affect health outcomes. Cross-sectional and prospective studies among diverse populations of persons living with HIV suggest that these behavioral mechanisms may be associated with HIV disease progression. The motivation to change behavior is often highest in the immediate aftermath of a stressor. However, over time the motivation to continue a particular behavior change is often challenged by habits, environmental influences, and psychosocial factors. Furthermore, a number of studies suggest that behavioral mechanisms may mediate the relationship between psychosocial variables (e.g., stress, depression, coping, and social support) and disease progression in HIV. Thus, developing clinical interventions that address these psychosocial factors and enhance protective health behaviors and reduce behaviors that convey risk to health are likely to lessen overall morbidity and mortality among patients living with HIV/AIDS.
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PMID:Behavioral mediation of the relationship between psychosocial factors and HIV disease progression. 1851 85

The objective of this study was to review original research on the intersection of violence against women by intimate partners and risk for HIV infection and highlight opportunities for new research and programme development. Seventy-one articles presenting original, peer-reviewed research conducted with females aged 12 years and older in heterosexual relationships during the past decade (1998-2007) were reviewed. Studies were eligible for inclusion if they addressed intimate partner violence (IPV) against women and HIV/AIDS as mutual risk factors. The prevalence of IPV and HIV infection among women varies globally, but females remain at elevated risk for both IPV and sexually transmitted/HIV infection, independently and concurrently. Comparisons between sero-negative and -positive women varied by geographic region; African HIV-positive women reported higher rates of victimisation while findings were inconsistent for HIV-positive women in the USA. Studies among various populations support the existence of a temporally and biologically complex relationship between HIV risk, lifetime exposure to violence and substance use, which are further complicated by gender and sexual decision-making norms. A possible link between violence-related post traumatic stress disorder and comorbid depression on immunity to HIV acquisition and HIV disease progression warrants further investigation. Sexual risk related to IPV works through both male and female behaviour, physiological consequences of violence and affects women across the lifespan. Further physiological and qualitative research is needed on the mechanisms of enhanced transmission; prospective studies are critical to address issues of causality and temporality. Prevention efforts should focus on the reduction of male-perpetrated IPV and male HIV risk behaviours in intimate partnerships.
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PMID:The intersection of intimate partner violence against women and HIV/AIDS: a review. 1905 Oct 85

Potent antiretroviral therapy (ART) has transformed HIV from a death sentence to a chronic illness. Accordingly, the goal of HIV care has shifted from delaying death to achieving optimal health outcomes through ART treatment. ART treatment success hinges on medication adherence. Extensive research has demonstrated that the primary barriers to ART adherence include mental illness, especially depression and substance abuse, as well as histories of traumatic experiences such as childhood sexual and physical abuse. These psychosocial factors are highly prevalent in people living with HIV/AIDS (PLWHA) and predict poor ART adherence, increased sexual risk behaviours, ART treatment failure, HIV disease progression and higher mortality rates. The efficacy of standard mental health interventions, such as antidepressant treatment and psychotherapy, has been well-defined, and a small but growing body of research demonstrates the potential for such interventions to improve ART adherence and reduce sexual risk behaviours. Despite this evidence, mental disorders in PLWHA frequently go undiagnosed and untreated. Challenges to the provision of mental healthcare for PLWHA in HIV clinical settings include time and resource constraints, lack of expertise in psychiatric diagnosis and treatment, and lack of available mental health referral services. Future research should prioritize the evaluation of mental health interventions that are cost-effective and feasible for widespread integration into HIV clinical care; the impact of such interventions on ART adherence and clinical outcomes; and interventions to identify individuals with histories of traumatic experiences and to elucidate the mechanisms through which such histories pose barriers to effective HIV treatment.
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PMID:The impact of mental health and traumatic life experiences on antiretroviral treatment outcomes for people living with HIV/AIDS. 1915 77


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