Inflammation and Risk of Depression in HIV: Prospective Findings From the Multicenter AIDS Cohort Study

Abstract Studies suggest that inflammation might be involved in the pathogenesis of depression. Individuals with human immunodeficiency virus (HIV) have a higher risk of depression and elevated inflammatory profiles. Despite this, research on the link between inflammation and depression among this high-risk population is limited. We examined a sample of men who have sex with men from the Multicenter AIDS Cohort Study in prospective analyses of the association between inflammation and clinically relevant depression symptoms, defined as scores >20 on Center for Epidemiological Studies Depression Scale. We included 1,727 participants who contributed 9,287 person-visits from 1984 to 2010 (8,218 with HIV (HIV+) and 1,069 without (HIV−)). Exploratory factor analysis (EFA) was used to characterize underlying inflammatory processes from 19 immune markers. Logistic regression with generalized estimating equations was used to evaluate associations between inflammatory processes and depressive symptoms stratified by HIV serostatus. Three EFA-identified inflammatory processes (EIPs) were identified. EIP-1 scores—described by soluble tumor necrosis factor receptor 2 (sTNF-R2), soluble interleukin-2 receptor α (sIL-2Rα), sCD27, B-cell activating factor, interferon γ-induced protein 10 (IP-10), soluble interleukin-6 receptor (sIL-6R), sCD14, and sGP130—were significantly associated with 9% higher odds of depressive symptoms in HIV+ participants (odds ratio = 1.09; 95% confidence interval: 1.03, 1.16) and 33% higher odds in HIV− participants (odds ratio = 1.33; 95% confidence interval: 1.09, 1.61). Findings suggest that immune activation might be involved in depression risk among both HIV+ and HIV− men who have sex with men.

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Back pain and depressive symptoms: A systematic review and meta-analysis

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217420913001 ◽

2020 ◽

pp. 009121742091300 ◽

Cited By ~ 1

Author(s):

Sohrab Amiri ◽

Sepideh Behnezhad ◽

Esfandiar Azad

Keyword(s):

Back Pain ◽

Depressive Symptoms ◽

Confidence Interval ◽

Publication Bias ◽

Odds Ratio ◽

Meta Analysis ◽

Depression Symptoms ◽

Psychological Consequences ◽

Cross Sectional ◽

Effective Prevention

Background Low back pain is a common disorder that has many consequences. This study is an attempt to meta-analyze the risk of depression symptoms in back pain. Method Four databases were selected for review, and this search was conducted using key words. Eleven eligible articles were selected for review and meta-analysis was conducted. Subgroup analyses were continued with study design and the method of measuring depression. Also, the heterogeneity and publication bias were examined. Results Eleven cohort and cross-sectional articles are used in the meta-analysis between back pain and depressive symptoms. The odds ratio 2.07 was calculated for this relationship. In prospective-cohort studies, 1.71 (95% confidence interval = 1.24–2.36) results indicated that back pain is a risk factor for depression symptoms and in cross-sectional studies, pooled odds ratio (2.33; 95% confidence interval = 1.29–4.21) showed that back pain is associated with depression symptoms. Some degree of publication bias was not found in the study. Conclusions Back pain is an effective factor in increasing the likelihood of depression. Adoption of effective prevention and treatment approaches can play an important role in reducing the psychological consequences in these individuals.

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Thyroid Function Within the Normal Range and the Risk of Depression: A Population-Based Cohort Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-3589 ◽

2014 ◽

Vol 99 (4) ◽

pp. 1213-1219 ◽

Cited By ~ 48

Author(s):

Marco Medici ◽

Nese Direk ◽

W. Edward Visser ◽

Tim I. M. Korevaar ◽

Albert Hofman ◽

...

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Confidence Interval ◽

Thyroid Function ◽

Odds Ratio ◽

Elderly Persons ◽

Normal Range ◽

Baseline Serum ◽

Increased Risk ◽

Depressive Syndromes

Context: Overt hypo- and hyperthyroidism are associated with an increased risk of depression. Little is known about the effects of variation in thyroid function within the normal range on the risk of depression. Objective: The objective of the study was to examine the association between normal-range thyroid function and the risk of depression. Design, Setting, and Participants: This was a cohort study in 1503 Dutch men and women, aged 70.6 (7.3) (mean [SD]) years. At baseline, serum TSH, thyroperoxidase antibody levels, and depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D)] were assessed. A CES-D of 16 or greater is indicative of a depressive disorder. During follow-up (mean 8.0 y), participants were continuously monitored for the occurrence of incident depressive syndromes (n = 156). Results: Cross-sectionally, persons in the lowest TSH tertile (0.3–1.0 mU/L) had more depressive symptoms [CES-D score (mean): 7.95 vs 6.63, P = .014] as well as an increased risk of a CES-D of 16 or greater [10.7% vs 5.0%, odds ratio (95% confidence interval) 2.22 (1.18–4.17)], compared with persons in the highest normal range TSH tertile (1.6–4.0 mU/L). In the prospective analyses, persons in the lowest TSH tertile who were depression free at baseline had a higher risk of incident depressive syndromes [12.3% vs 7.6%, odds ratio (95% confidence interval) 1.85 (1.10–3.11)]. Thyroid autoimmunity (thyroperoxidase antibody positivity) was not associated with CES-D scores or incident depressive syndromes. Conclusions: Elderly persons with low-normal TSH levels have more concurrent depressive symptoms as well as a substantially increased risk of developing a depressive syndrome in the subsequent years. This study identifies low-normal TSH as an important risk factor for depression in the elderly.

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Elevated Midpregnancy Corticotropin-Releasing Hormone Is Associated with Prenatal, But Not Postpartum, Maternal Depression

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-2535 ◽

2008 ◽

Vol 93 (5) ◽

pp. 1946-1951 ◽

Cited By ~ 49

Author(s):

J. W. Rich-Edwards ◽

A. P. Mohllajee ◽

K. Kleinman ◽

M. R. Hacker ◽

J. Majzoub ◽

...

Keyword(s):

Depressive Symptoms ◽

Postpartum Depression ◽

Confidence Interval ◽

Odds Ratio ◽

Depression Scale ◽

Prenatal Depression ◽

Depression Symptoms ◽

Logarithmic Scale ◽

Postpartum Depressive Symptoms ◽

Scale Range

Abstract Context: Elevated hypothalamic CRH has been implicated in melancholic major depression in nonpregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored. Objective: The objective of the study was to examine the association of maternal midpregnancy plasma CRH levels with prenatal and postpartum depression. Participants: The study included 800 participants in Project Viva, a pregnancy and childhood cohort. Methods: CRH levels were analyzed from blood samples obtained at mean 27.9 wk gestation (± 1.3 sd; range 24.6–37.4 wk) and were normalized on the logarithmic scale. Depression was assessed with the Edinburgh Postpartum Depression Scale (range 0–30 points) in midpregnancy and at 6 months postpartum. We used logistic regression to estimate the odds of scoring 13 or more points on the Edinburgh Postpartum Depression Scale as indicative of major or minor depression. Results: Seventy (8.8%) and 46 (7.5%) women had prenatal and postpartum depression symptoms, respectively. Mean log CRH was 4.93 (± 0.62 sd). After adjusting for confounders, an sd increase in log CRH was associated with nearly 50% higher odds of prenatal depression symptoms (odds ratio 1.48, 95% confidence interval 1.14–1.93). Higher CRH levels during pregnancy were unassociated with greater risk of postpartum depressive symptoms. In fact, there was a suggestion that prenatal CRH levels might be inversely associated with risk of postpartum depressive symptoms (odds ratio 0.82, 95% confidence interval 0.58–1.15). Conclusions: Elevated placental CRH levels in midpregnancy are positively associated with risk of prenatal depression symptoms but not postpartum depression symptoms.

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Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China

Sexual Health ◽

10.1071/sh14017 ◽

2014 ◽

Vol 11 (3) ◽

pp. 285 ◽

Cited By ~ 14

Author(s):

Huamei Yan ◽

Frank Y. Wong ◽

Tony Zheng ◽

Zhen Ning ◽

Yingying Ding ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Confidence Interval ◽

Odds Ratio ◽

Protective Factor ◽

Depression Scale ◽

Cutoff Score ◽

Social Provision ◽

Sex With Men ◽

Money Boys

The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as ‘money boys’ (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d. = 6.53) for MBs and 69.3 (s.d. = 6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio = 1.86, 95% confidence interval = 1.07–3.24). Social support was a protective factor for depressive symptoms (odds ratio = 0.92, 95% confidence interval = 0.89–0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.

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Does Social Support Predict Depressive Symptoms? A Longitudinal Study of Midlife and Older Men Who Have Sex with Men from the Multicenter AIDS Cohort Study

Annals of LGBTQ Public and Population Health ◽

10.1891/lgbtq-2020-0042 ◽

2021 ◽

pp. LGBTQ-2020-0042

Author(s):

Emmett R. Henderson ◽

James E. Egan ◽

Sabina A. Haberlen ◽

Roger Detels ◽

Linda A. Teplin ◽

...

Keyword(s):

Social Support ◽

Cohort Study ◽

Depressive Symptoms ◽

Healthy Aging ◽

Latent Class ◽

Common Type ◽

Final Visit ◽

Multicenter Aids Cohort Study ◽

Sex With Men ◽

Levels Of Support

The present study was designed to identify social support classes across time among midlife (40–64 years) and older (65+ years) gay, bisexual, and other men who have sex with men (MSM), and whether social support protects against depressive symptoms in this population. This study applied longitudinal latent class analysis across five visits on 1,329 individuals age 40 or older at baseline using data from the Multicenter AIDS Cohort Study (MACS) Healthy Aging substudy collected from April 2016 to October 2018. We identified four classes of social support across time: Partner-centered, that is, high levels of support from one's primary partner(s) and moderate support from friends and family; Friend-centered, that is, high levels of support from friends and chosen family; Low, that is, low levels of support from all sources; and Robust, that is, high levels of support from all sources. We found differences in class membership by age, race/ethnicity, employment status, sexual identity, education, relationship status, and HIV status. Finally, compared to MSM in the low support class, men in the other classes had lower odds of depressive symptoms at the final visit. The most common type of social support was partner-centered, while the least common type was robust. These findings suggest that the presence of any social support, regardless of the source, protects against depressive symptoms.

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Bidirectional Association Between Knee Osteoarthritis and Depressive Symptoms: A Nationwide Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.710 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 220-220

Author(s):

Han Lu ◽

Shaomei Shang ◽

Limin Wang ◽

Hongbo Chen

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Knee Osteoarthritis ◽

Proportional Hazards ◽

Depression Scale ◽

Cox Proportional Hazards ◽

Depression Symptoms ◽

Physical And Mental Health ◽

Bidirectional Association ◽

Bidirectional Relationship

Abstract Both knee osteoarthritis (KOA) and depressive symptoms are common health issues affecting the quality of life of old adults. Although it is presumed that KOA has a bidirectional relationship with the depressive symptoms, no cohort study has proven it. This is the first study to determine the strength of association for the bidirectional relationship between KOA and depressive symptoms. Data were gathered from the nationally survey of China Health and Retirement Longitudinal Study in 2011-2015. The presence of depressive symptoms was defined by the 10-item Center for Epidemiologic Studies Depression Scale score of 10 or higher. The adjusted Cox proportional hazards regression model was conducted to estimate hazards ratios (HRs). Controlled covariates include gender, age, education, marital status, residence, number of chronic diseases, and disability. The analysis of KOA predicting the depressive symptoms onset consisted of 4,377 participants free from depressive symptoms at baseline. During 4 years follow-up, diagnosed KOA participants were more likely to have depressive symptoms than their peers without KOA (HR = 1.50, 95% CI: 1.23-1.83). The parallel analysis of depressive symptoms predicting KOA onset included 6,848 participants without KOA at baseline, those with depressive symptoms had a higher relative risk of developing KOA (HR = 1.64, 95% CI: 1.41-1.92). Our results provide compelling evidence that the KOA-depressive symptoms association is bidirectional, highlighting the importance of evaluating the relationship between physical and mental health among older people. Particularly, taking this association into consideration in the risk assessment and primary prevention of KOA and depression symptoms.

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Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/0956462416636780 ◽

2016 ◽

Vol 28 (6) ◽

pp. 573-583 ◽

Cited By ~ 6

Author(s):

Jamie Frankis ◽

Lisa Goodall ◽

Dan Clutterbuck ◽

Abdul-Razak Abubakari ◽

Paul Flowers

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Anal Intercourse ◽

Sex Partners ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing ◽

Male Sex ◽

Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

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β-Blockers, Tachycardia, and Survival Following Sepsis: An Observational Cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciab034 ◽

2021 ◽

Author(s):

Dmitri Guz ◽

Shira Buchritz ◽

Alina Guz ◽

Alon Ikan ◽

Tania Babich ◽

...

Keyword(s):

Internal Medicine ◽

Cohort Study ◽

Mortality Rate ◽

Confidence Interval ◽

Odds Ratio ◽

Observational Cohort Study ◽

Observational Cohort ◽

Internal Medicine Wards ◽

Β Blockers

Abstract Background Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. Methods We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). Results A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age [interquartile range], 74 [62–82] vs 81 [68–87] years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177–.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148–.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. Conclusions Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

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Factors Associated With HIV Testing in Teenage Men Who Have Sex With Men

10.1542/9781610025409-factors ◽

2021 ◽

pp. 31-39

Author(s):

Brian Mustanski ◽

David A. Moskowitz ◽

Kevirj O. Moran ◽

H. Jonathon Rendina ◽

Michael E. Newcomb ◽

...

Keyword(s):

Confidence Interval ◽

Hiv Testing ◽

Sexual Behaviors ◽

Odds Ratio ◽

Hiv Knowledge ◽

Hiv Prevention Intervention ◽

Hiv Test ◽

Sexual Health Communication ◽

Sex With Men ◽

Regular Doctor

BACKGROUND Adolescent men who have sex with men (AMSM) have a high rate of HIV diagnoses. An estimated 14.5% of HIV infections in the United States are undiagnosed; but among 13- to 24-year-olds, the rate is 51.4%. We describe HIV testing rates and identifies salient individual, family, school, and health care influences among AMSM. METHODS Data were collected as part of SMART, an ongoing pragmatic trial of an online HIV prevention intervention for AMSM (N = 699). Measures included lifetime HIV testing, demographics, sexual behaviors, condom use, HIV education from school and family, sexual health communication with doctors, HIV knowledge, and risk attitudes. RESULTS Only 23.2% of participants had ever had an HIV test. Rates of testing increased with age (5.6% in 13- to 14-year-olds; 15.8% in 15- to 16-year-olds; 37.8% in 17- to 18-year-olds), and sexual experience was a strong predictor of testing (odds ratio: 6.54; 95% confidence interval: 3.95–11.49; P < .001). Most participants had a regular doctor (67.5%), but few had conversations about same-sex sexual behaviors (21.3%), HIV testing (19.2%), or sexual orientation (29.2%). Speaking to a doctor about HIV testing had a large effect (odds ratio: 25.29; confidence interval: 15.91–41.16; P < .001), with 75.4% who had such conversations having been tested, compared to only 10.8% of those who had not had such conversations. CONCLUSIONS Despite higher risk, few participants reported ever having received an HIV test. Data indicate pediatricians are an important, but largely untapped, source of testing and could be integral to achieving testing rates needed to end the epidemic.

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Understanding patterns and factors associated with place of death in patients with end-stage kidney disease: A retrospective cohort study

Palliative Medicine ◽

10.1177/0269216316655747 ◽

2016 ◽

Vol 31 (3) ◽

pp. 283-288 ◽

Cited By ~ 9

Author(s):

Natasha Lovell ◽

Chris Jones ◽

Dawn Baynes ◽

Sarah Dinning ◽

Katie Vinen ◽

...

Keyword(s):

Cohort Study ◽

Kidney Disease ◽

Confidence Interval ◽

Retrospective Cohort Study ◽

Odds Ratio ◽

Retrospective Cohort ◽

Place Of Death ◽

Renal Unit ◽

End Stage Kidney Disease ◽

End Stage

Background: Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. Aim: To understand patterns of place of death in patients with end-stage kidney disease known in one UK renal unit. Design: A retrospective cohort study of all patients with chronic kidney disease stage 4–5, age ⩾75 and known to one UK renal unit, who died between 2006 and 2012. Patients were categorised into three management pathways: haemodialysis, conservative and pre-dialysis. Results: A total of 321 patients (mean age, 82.7; standard deviation, 5.21) died (61.7% male). In all, 62.9% died in hospital (95% confidence interval, 57.5%–68.1%), 21.8% died in their usual place of residence (95% confidence interval, 17.5%–26.6%) and 15.3% died in an inpatient palliative care unit (95% confidence interval, 11.6%–19.5%). Management pathway and living circumstances were most strongly associated with place of death. Patients on the conservative pathway had four times the odds of dying out of hospital (odds ratio, 4.0; 95% confidence interval, 2.1–7.5; p < 0.01). Patients living alone were less likely to die out of hospital (odds ratio, 0.3; 95% confidence interval, 0.1–0.6; p < 0.01). There were also changes in place of death over time, with more patients dying out of hospital in 2012 compared to 2006 (odds ratio, 3.1; 95% confidence interval, 1.0–9.7; p < 0.05). Conclusion: Most patients with end-stage kidney disease die in hospital, but patients managed without dialysis are significantly more likely to die outside of hospital. Planning ahead is key to be able to meet preference for place of death.

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