Trajectories of Depressive Symptoms Among a Population of HIV-Infected Men and Women in Routine HIV Care in the United States

  • Angela M. Bengtson
  • Brian W. Pence
  • Kimberly A. Powers
  • Mark A. Weaver
  • Matthew J. Mimiaga
  • Bradley N. Gaynes
  • Conall O’Cleirigh
  • Katerina Christopoulos
  • W. Christopher Mathews
  • Heidi Crane
  • Michael Mugavero
Original Paper

Abstract

Depressive symptoms vary in severity and chronicity. We used group-based trajectory models to describe trajectories of depressive symptoms (measured using the Patient Health Questionnaire-9) and predictors of trajectory group membership among 1493 HIV-infected men (84%) and 292 HIV-infected women (16%). At baseline, 29% of women and 26% of men had depressive symptoms. Over a median of 30 months of follow-up, we identified four depressive symptom trajectories for women (labeled “low” [experienced by 56% of women], “mild/moderate” [24%], “improving” [14%], and “severe” [6%]) and five for men (“low” [61%], “mild/moderate” [14%], “rebounding” [5%], “improving” [13%], and “severe” [7%]). Baseline antidepressant prescription, panic symptoms, and prior mental health diagnoses were associated with more severe or dynamic depressive symptom trajectories. Nearly a quarter of participants experienced some depressive symptoms, highlighting the need for improved depression management. Addressing more severe or dynamic depressive symptom trajectories may require interventions that additionally address mental health comorbidities.

Keywords

Depression Depressive symptoms Trajectory analysis Group-based trajectory models HIV 

Notes

Acknowledgements

The authors wish to thank the University of North Carolina at Chapel Hill Center for AIDS Research and National Institutes of Health [Grant Numbers R01MH100970, R24AI067039, P30 AI50410, L30MH110572, K99MH112413, and UL1TR001111], which supported this work. Dr. Bengtson was supported by a career development award from the National Institute of Mental Health [Grant Number K99MH112413].

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board at each CNICS site and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent to participate in the CNICS cohort was obtained from all individual participants included in the study.

Informed Consent

Informed consent to participate in the CNICS cohort was obtained from all individual participants included in the study.

Supplementary material

10461_2018_2109_MOESM1_ESM.docx (39 kb)
Supplementary material 1 (DOCX 38 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Angela M. Bengtson
    • 1
  • Brian W. Pence
    • 1
  • Kimberly A. Powers
    • 1
  • Mark A. Weaver
    • 2
    • 3
  • Matthew J. Mimiaga
    • 4
    • 5
    • 6
  • Bradley N. Gaynes
    • 7
  • Conall O’Cleirigh
    • 8
    • 9
    • 10
  • Katerina Christopoulos
    • 11
  • W. Christopher Mathews
    • 12
  • Heidi Crane
    • 13
  • Michael Mugavero
    • 14
  1. 1.Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Departments of Behavioral & Social Health Sciences and Epidemiology, School of Public HealthBrown UniversityProvidenceUSA
  5. 5.Department of Psychiatry & Human Behavior, Alpert Medical SchoolBrown UniversityProvidenceUSA
  6. 6.The Center for Health Equity ResearchBrown UniversityProvidenceUSA
  7. 7.Department of Psychiatry, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  8. 8.Department of PsychiatryMassachusetts General HospitalBostonUSA
  9. 9.Harvard Medical SchoolHarvard UniversityBostonUSA
  10. 10.The Fenway Institute, Fenway HealthBostonUSA
  11. 11.HIV/AIDS Division, San Francisco General HospitalUniversity of CaliforniaSan FranciscoUSA
  12. 12.Department of Medicine, School of MedicineUniversity of CaliforniaSan DiegoUSA
  13. 13.Department of Medicine, School of MedicineUniversity of WashingtonSeattleUSA
  14. 14.Department of Medicine and UAB Center for AIDS ResearchUniversity of Alabama at BirminghamBirminghamUSA

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