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

AIDS Behav. 2018 Oct;22(10):3176-3187. doi: 10.1007/s10461-018-2109-2.

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; Group-based trajectory models; HIV; Trajectory analysis.

MeSH terms

  • Adult
  • Comorbidity
  • Depression / diagnosis*
  • Depression / epidemiology
  • Depression / psychology*
  • Depressive Disorder / epidemiology
  • Female
  • HIV Infections / epidemiology
  • Humans
  • Male
  • Mass Screening / methods*
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • United States / epidemiology