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December 1, 1993, Vol 270, No. 21 >
ARTICLE | December 1, 1993

Depression and HIV How Does One Affect the Other? FREE

Samuel Perry, MD; Baruch Fishman, PhD
[+] Author Affiliations

Reprint requests to 525 E 68th St, New York, NY 10021 (Dr Perry).


JAMA. 1993;270(21):2609-2610. doi:10.1001/jama.1993.03510210095036
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References

The course of human immunodeficiency virus (HIV) disease varies widely. Some patients deteriorate rapidly while others live for years, even after an illness that defines the acquired immunodeficiency syndrome (AIDS). The reasons for these different rates of decline are not known, but psychosocial variables have been put on the list of possible host factors.1 The notion has been that one's adaptive coping or fighting spirit might somehow delay or even prevent HIV's inexorable attack—and conversely, that distress and despair might measurably accelerate progression of the disease.

See also pp 2563 and 2568.

Such a notion is based on more than the understandable hope that one's mind can prevail over an illness with no known medical cure. Accumulating evidence supports the belief held since Hippocrates that vigor, resilience, and perceived support are associated with more favorable medical outcomes.2 Furthermore, stress and depression have been shown to affect the immune

REFERENCES

1 +
Fauci AS.  The human immunodeficiency virus: infectivity and mechanisms of pathogenesis. Science . 1988;;239:617-622.
2 +
Solomon GF, Kemeny ME, Temoshok L.  Psychoimmunologic aspects of human immunodeficiency virus infection.  In: Adar R, Felten DL, Cohnen N, eds. Psychoneuroimmunology . 2nd ed. Orlando, Fla: Academic Press Inc; 1990;:1081-1113.
3 +
Spiegel D, Bloom DR, Kraemer H, Gottheil E.  Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet . 1989;;2:888-891.
4 +
Irwin M, Patterson T, Smith TL, et al.  Reduction of immune function in life stress and depression. Biol Psychiatry . 1990;;27:22-30.
5 +
Lyketsos CG, Hoover DR, Guccione M, et al.  Depressive symptoms as predictors of medical outcomes in HIV infection. JAMA . 1993;;270:2563-2567.
6 +
Burack JH, Barrett DC, Stall RD, Chesney MA, Ekstrand ML, Coates TJ.  Depressive symptoms and CD4 lymphocyte decline among HIV-infected men. JAMA . 1993;;270:2568-2573.
7 +
Rabkin JG, Williams JBW, Remien RH, Goetz R, Kertzner R, Gorman JM.  Depression, distress, lymphocyte subsets, and human immunodeficiency virus symptoms on two occasions in HIV-positive homosexual men. Arch Gen Psychiatry . 1991;;48:111-119.
8 +
Kessler RC, Foster C, Joseph J, et al.  Stressful life events and symptom onset in HIV infection. Am J Psychiatry . 1991;;148:733-738.
9 +
Perry S, Fishman B, Jacobsberg L, Francis A.  Relationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus. Arch Gen Psychiatry . 1992;;49:396-401.
10 +
Radloff LS.  The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measurement . 1977;;1:385-401.
11 +
Williams JBW, Rabkin JG, Remien RH, Gorman JM, Ehrhardt AA.  Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection, II: standardized clinical assessment of current and lifetime psychopathology. Arch Gen Psychiatry . 1991;;48:124-130.
12 +
Hays RB, Turner H, Coates TJ.  Social support, AIDS-related symptoms, and depression among gay men. J Consult Clin Psychol . 1992;;60:463-469.
13 +
Perry S, Jacobsberg L, Card C, Ashman T, Frances A, Fishman B.  Severity of psychiatric symptoms after HIV testing. Am J Psychiatry . 1993;;150:775-779.
14 +
Perry S.  HIV-related depression.  In: Price R, Perry S, eds. HIV, AIDS, and the Brain . New York, NY: Raven Press; 1993;:233-238.
15 +
Stein M, Miller AH, Trestman RL.  Depression, the immune system, and health and illness: findings in search of meaning. Arch Gen Psychiatry . 1991;;48:171-177.
16 +
Fahey J, Taylor J, Detels R, et al.  The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med . 1990;;322:166-172.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Fauci AS.  The human immunodeficiency virus: infectivity and mechanisms of pathogenesis. Science . 1988;;239:617-622.
2 +
Solomon GF, Kemeny ME, Temoshok L.  Psychoimmunologic aspects of human immunodeficiency virus infection.  In: Adar R, Felten DL, Cohnen N, eds. Psychoneuroimmunology . 2nd ed. Orlando, Fla: Academic Press Inc; 1990;:1081-1113.
3 +
Spiegel D, Bloom DR, Kraemer H, Gottheil E.  Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet . 1989;;2:888-891.
4 +
Irwin M, Patterson T, Smith TL, et al.  Reduction of immune function in life stress and depression. Biol Psychiatry . 1990;;27:22-30.
5 +
Lyketsos CG, Hoover DR, Guccione M, et al.  Depressive symptoms as predictors of medical outcomes in HIV infection. JAMA . 1993;;270:2563-2567.
6 +
Burack JH, Barrett DC, Stall RD, Chesney MA, Ekstrand ML, Coates TJ.  Depressive symptoms and CD4 lymphocyte decline among HIV-infected men. JAMA . 1993;;270:2568-2573.
7 +
Rabkin JG, Williams JBW, Remien RH, Goetz R, Kertzner R, Gorman JM.  Depression, distress, lymphocyte subsets, and human immunodeficiency virus symptoms on two occasions in HIV-positive homosexual men. Arch Gen Psychiatry . 1991;;48:111-119.
8 +
Kessler RC, Foster C, Joseph J, et al.  Stressful life events and symptom onset in HIV infection. Am J Psychiatry . 1991;;148:733-738.
9 +
Perry S, Fishman B, Jacobsberg L, Francis A.  Relationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus. Arch Gen Psychiatry . 1992;;49:396-401.
10 +
Radloff LS.  The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measurement . 1977;;1:385-401.
11 +
Williams JBW, Rabkin JG, Remien RH, Gorman JM, Ehrhardt AA.  Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection, II: standardized clinical assessment of current and lifetime psychopathology. Arch Gen Psychiatry . 1991;;48:124-130.
12 +
Hays RB, Turner H, Coates TJ.  Social support, AIDS-related symptoms, and depression among gay men. J Consult Clin Psychol . 1992;;60:463-469.
13 +
Perry S, Jacobsberg L, Card C, Ashman T, Frances A, Fishman B.  Severity of psychiatric symptoms after HIV testing. Am J Psychiatry . 1993;;150:775-779.
14 +
Perry S.  HIV-related depression.  In: Price R, Perry S, eds. HIV, AIDS, and the Brain . New York, NY: Raven Press; 1993;:233-238.
15 +
Stein M, Miller AH, Trestman RL.  Depression, the immune system, and health and illness: findings in search of meaning. Arch Gen Psychiatry . 1991;;48:171-177.
16 +
Fahey J, Taylor J, Detels R, et al.  The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med . 1990;;322:166-172.

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