Psychological burden in the era of HAART: impact of selenium therapy

Int J Psychiatry Med. 2003;33(1):55-69. doi: 10.2190/PFFD-D920-V041-N5KD.

Abstract

Objective: To determine the impact of nutritional (selenium) chemoprevention on levels of psychological burden (anxiety, depression, and mood state) in HIV/AIDS.

Method: A randomized, double-blind, placebo-controlled selenium therapy (200 microg/day) trial was conducted in HIV+ drug users from 1998-2000. Psychosocial measures (STAI-State and Trait anxiety, BDI-depression, and POMS- mood state), clinical status (CD4 cell count, viral load), and plasma selenium levels were determined at baseline and compared with measurements obtained at the 12-month evaluation in 63 participants (32 men, 31 women).

Results: The majority of the study participants reported elevated levels of both State (68%) and Trait (70%) anxiety. Approximately 25% reported overall mood distress (POMS > 60) and moderate depression (BDI > 20). Psychological burden was not influenced by current drug use, antiretroviral treatment, or viral load. At the 12-month evaluation, participants who received selenium reported increased vigor (p = 0.004) and had less anxiety (State, p = 0.05 and Trait, p = 0.02), compared to the placebo-treated individuals. No apparent selenium-related affect on depression or distress was observed. The risk for state anxiety was almost four times higher, and nearly nine times greater for trait anxiety in the placebo-treated group, controlling for antiretroviral therapy, CD4 cell decline (> 50 cells) and years of education.

Conclusions: Selenium therapy may be a beneficial treatment to decrease anxiety in HIV+ drug users who exhibit a high prevalence of psychological burden.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antioxidants / administration & dosage*
  • Antiretroviral Therapy, Highly Active
  • Anxiety / etiology
  • Anxiety / prevention & control*
  • CD4 Lymphocyte Count
  • Cost of Illness*
  • Depression / etiology
  • Depression / prevention & control*
  • Dietary Supplements*
  • Female
  • Florida
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / etiology
  • HIV Infections / psychology*
  • HIV-1 / drug effects
  • Humans
  • Logistic Models
  • Male
  • Micronutrients / administration & dosage*
  • Micronutrients / blood
  • Middle Aged
  • Mood Disorders / etiology
  • Mood Disorders / prevention & control*
  • Prevalence
  • Selenium / administration & dosage*
  • Selenium / blood
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / virology
  • Treatment Outcome

Substances

  • Antioxidants
  • Micronutrients
  • Selenium