GMHC Treatment Issues 1994 Jun 1; 8(4): 19
Two studies on depression and disease progression among HIV-
positive individuals were recently published in The Journal of
the American Medical Association (JAMA, 1993; 270: 2563- 74).
One group of researchers, Lyketsos, et al. from the Multicenter
AIDS Cohort Study (MACS), found that depression was not
associated with increased disease progression or death.
However, another study, published in the same edition, by
Burack, et al. from San Francisco General Hospital, concluded
that "depression predicted a more rapid decline" in CD4 counts.
The first study, which did not find an association, was
significantly larger than the second. It measured not only CD4
counts but "at least five assessments" of disease progression.
An editorial entitled "Depression and HIV: How Does One Affect
the Other?" accompanied the two reports. It noted, "We are
reminded by both studies that most HIV-infected subjects are
The editorial continued, "We continue to urge clinicians to
view depression in this population as a psychopathological
condition warranting treatment to reduce suffering and to
improve functioning. But we also recommend that clinicians be
cautious in suggesting that HIV-infected patients should reduce
their depression because of its direct effects on their
T-cells. Such a stance is not well substantiated and may foster
self-accusation when disease progression occurs."
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