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Changes in depressive symptoms as AIDS develops. The Multicenter AIDS Cohort Study

C G Lyketsos¹, D R Hoover, M Guccione

¹Johns Hopkins University, Baltimore, MD 21287-5371, USA.

The American Journal of Psychiatry

|November 1, 1996

Summary

Depressive symptoms significantly increase in the 18 months leading up to an AIDS diagnosis, with predictors including prior depression and HIV-related symptoms. This rise is sustained and warrants further study in HIV-1 infection.

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Area of Science:

Psychiatry
Infectious Diseases
Epidemiology

Background:

HIV-1 infection progresses through stages, impacting physical and mental health.
Depressive symptoms are a common comorbidity in individuals with HIV-1.
Understanding the trajectory of depression is crucial for patient care.

Purpose of the Study:

To investigate changes in depressive symptoms from early to late-stage HIV-1 infection.
To identify predictors of depressive symptoms as Acquired Immunodeficiency Syndrome (AIDS) develops.

Main Methods:

Longitudinal study of 911 HIV-seropositive men from the Multicenter AIDS Cohort Study.
Semiannual follow-ups over a 10-year period.
Assessment of depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D Scale) up to 5 years before and 2 years after AIDS diagnosis.

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Main Results:

Depressive symptoms remained stable until 12-18 months before AIDS diagnosis.
A significant increase in depressive symptoms occurred, plateauing 6 months before AIDS diagnosis.
Predictors of increased depression included early elevated CES-D scores, self-reported AIDS-related symptoms, unemployment, smoking, and limited social support.

Conclusions:

A dramatic and sustained rise in depressive symptoms occurs as AIDS develops, starting as early as 18 months prior.
Pre-existing depression, HIV disease factors, and psychological stressors contribute to this phenomenon.
Further research is needed to fully characterize this robust increase in depression.