The effects of depression, stressful life events, social support, and coping on the progression of HIV infection
Current Psychiatry ReportsPublished 1 December 2000
Jane Leserman
Citations43
SJR quartileQ1
SJR score2.37
SNIP2.24
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TL;DR
The role of depression, stressful life events, social support, and coping on changes in CD4 T-lymphocytes and other indicators of HIV disease progression is examined.
Abstract
This article reviews recent findings concerning the role of psychosocial factors on the progression of HIV. Specifically, we examine the role of depression, stressful life events, social support, and coping on changes in CD4 T-lymphocytes and other indicators of HIV disease progression. Studies have yielded important evidence that depression, stressful life events, low social support, and denial coping may have a detrimental impact on HIV disease course. Delineating the role of psychosocial factors on HIV disease progression may aid in the development of new interventions for this devastating disease.
Keywords
MedicineHealth Professions
Journal of Neurology Neurosurgery & PsychiatryA RATING SCALE FOR DEPRESSION
32,633 Citations1960M. Hamilton
The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.
Journal of Personality and Social PsychologyAssessing coping strategies: A theoretically based approach.
9,304 Citations1989Charles S. Carver, M F Scheier +1 more
The LancetEFFECT OF PSYCHOSOCIAL TREATMENT ON SURVIVAL OF PATIENTS WITH METASTATIC BREAST CANCER
2,368 Citations1989David Spiegel, H C Kraemer +2 more
The effect of psychosocial intervention on time of survival of 86 patients with metastatic breast cancer was studied prospectively and survival plots indicated that divergence in survival began at 20 months after entry, or 8 months after intervention ended.
JAMADepression Following Myocardial Infarction
1,943 Citations1993Nancy Frasure‐Smith
Major depression in patients hospitalized following an MI is an independent risk factor for mortality at 6 months and its impact is at least equivalent to that of left ventricular dysfunction (Killip class) and history of previous MI.
CirculationDepression and 18-Month Prognosis After Myocardial Infarction
1,562 Citations1995Nancy Frasure‐Smith, François Lespérance +1 more
Depression while in the hospital after an MI is a significant predictor of 18-month post- MI cardiac mortality and significantly improves a risk-stratification model based on traditional post-MI risks, including previous MI, Killip class, and PVCs.
Psychosomatic MedicineStress and immunity in humans: a meta-analytic review.
1,097 Citations1993Tracy B. Herbert, Sheldon Cohen
The way neuroendocrine mechanisms and health practices might explain immune alteration following stress, and issues that need to be investigated in this area are outlined.
Archives of General PsychiatryMalignant Melanoma
1,036 Citations1993F I Fawzy
Psychiatric interventions that enhance effective coping and reduce affective distress appear to have beneficial effects on survival but are not proposed as an alternative or independent treatment for cancer or any other illness or disease.
Psychological BulletinDepression and immunity: A meta-analytic review.
802 Citations1993Tracy B. Herbert, Sheldon Cohen
A meta-analysis indicated that clinical depression was associated with several large alterations in cellular immunity, and there was also evidence of a linear relation between intensity of depressive affect and indicators of cellular immunity.
ScienceMultifactorial Nature of Human Immunodeficiency Virus Disease: Implications for Therapy
786 Citations1993Anthony S. Fauci
Psychosomatic MedicineProgression to AIDS
442 Citations1999Jane Leserman, Eric D. Jackson +7 more
Data are among the first to demonstrate that more stress and less social support may accelerate the course of HIV disease progression, and additional study will be necessary to elucidate the mechanisms that underlie these relationships.
JAMADepressive Symptoms and CD4 Lymphocyte Decline Among HIV-Infected Men
360 Citations1993Jeffrey H. Burack
Overall depression and affective depression predicted a more rapid decline in CD4 lymphocyte counts; this association was not attributable to baseline physiological differences and can be explained neither as a reflection of perceived somatic symptoms nor as the result of differences in recreational drug and alcohol use.
PubMedDeaths: final data for 1997.
360 Citations1999Donna L. Hoyert, Kenneth D. Kochanek +1 more
The overall improvements in general mortality and life expectancy in 1997 continue the long-term downward trend in U.S. mortality.
Psychosomatic MedicineSexual and Physical Abuse History in Gastroenterology Practice
351 Citations1996Jane Leserman, Douglas A. Drossman +4 more
It is found that asking about abuse should be integrated into history taking within referral-based gastroenterology practices and seem to have worse health effects than less serious physical violence, and sexual abuse involving attempts and touch.
American Journal of PsychiatryImpact of Stressful Life Events, Depression, Social Support, Coping, and Cortisol on Progression to AIDS
342 Citations2000Jane Leserman, John M. Petitto +7 more
Faster progression to AIDS was associated with higher cumulative average stressful life events, coping by means of denial, and higher serum cortisol as well as with lower cumulative average satisfaction with social support and tobacco use, risky sexual behavior.
JAMADepression and Mortality
331 Citations1991Barry W. Rovner
Major depressive disorder, but not depressive symptoms, was a risk factor for mortality over 1 year independent of selected physical health measures and increased the likelihood of death by 59%.
Archives of General PsychiatryDepression, the Immune System, and Health and Illness
297 Citations1991Marvin Stein, Andrew H. Miller +1 more
There has been a lack of substantial evidence supporting the association between depression or stress and increased morbidity or mortality due to disorders involving the immune system.
Psychosomatic MedicineChanges in Cognitive Coping Skills and Social Support During Cognitive Behavioral Stress Management Intervention and Distress Outcomes in Symptomatic Human Immunodeficiency Virus (HIV)-Seropositive Gay Men
242 Citations1998Susan K. Lutgendorf, Michael H. Antoni +7 more
It is suggested that cognitive coping and social support factors can be modified by psychosocial interventions and may be important determinants of the changes in psychological well-being and quality of life during symptomatic HIV infection that can be achieved through this form of intervention.
JAMADepressive Symptoms as Predictors of Medical Outcomes in HIV Infection
238 Citations1993Constantine G. Lyketsos
There is no evidence that depressive symptoms independently prognosticate worse outcomes in HIV infection, and future studies of the relationship between depression and HIV outcome should consider these variables as confounders.
Psychosomatic MedicineAccelerated Course of Human Immunodeficiency Virus Infection in Gay Men Who Conceal Their Homosexual Identity
236 Citations1996Steve W. Cole, Margaret E. Kemeny +3 more
HIV infection appears to progress more rapidly in gay men who conceal their homosexual identity, consistent with hypotheses about the health effects of psychological inhibition, but further research is required to definitively identify the psychosocial, behavioral, and physiological mechanisms underlying these findings.
American Journal of PsychiatryChanges in depressive symptoms as AIDS develops. The Multicenter AIDS Cohort Study
231 Citations1996Constantine G. Lyketsos, Donald R. Hoover +5 more
There is a draniatic, sustained rise in depressive symptoms as AIDS develops, beginning as early as 18 months before clinical A IDS is diagmiosed, and prior depression, HI V-disease-related factors, and psychological stressors contribute to this rise.
Archives of General PsychiatryDepression, Distress, Lymphocyte Subsets, and Human Immunodeficiency Virus Symptoms on Two Occasions in HIV-Positive Homosexual Men
224 Citations1991Judith G. Rabkin
The HIV-positive men who were depressed or distressed or who reported more life stressors had no greater immunosuppression or more advanced illness stage than did the others, either concurrently or across occasions.
Archives of General PsychiatrySevere Stress, Depressive Symptoms, and Changes in Lymphocyte Subsets in Human Immunodeficiency Virus—Infected Men
220 Citations1997Jane Leserman
The findings are among the first prospective data showing that stress and depressive symptoms, especially when they occur jointly, are associated with decreased number of NK and CD8+ T lymphocytes in HIV-infected men.
BMJStress and relapse of breast cancer.
218 Citations1989Antonio J. Ramírez, Tom Craig +4 more
A prognostic association between severe life stressors and recurrence of breast cancer is suggested, but a larger prospective study is needed for confirmation.
Archives of General PsychiatryRelationships Over 1 Year Between Lymphocyte Subsets and Psychosocial Variables Among Adults With Infection by Human Immunodeficiency Virus
202 Citations1992Samuel W. Perry
It is concluded that among the authors' sample, physical symptoms contributed to emotional distress, but emotional distress did not contribute to the CD4 cell count, a marker of disease progression.
Proceedings of the National Academy of SciencesSocial stress results in altered glucocorticoid regulation and shorter survival in simian acquired immune deficiency syndrome
193 Citations1998John P. Capitanio, Sally P. Mendoza +2 more
The results indicate that social factors can have a significant impact on the course of immunodeficiency disease and Socially induced changes in pituitary-adrenal hormones may be one mechanism mediating this relationship.
Archives of Internal MedicineDepressive Affect and Survival Among Gay and Bisexual Men Infected With HIV
192 Citations1996Tracy J. Mayne
Depressive affect was associated with mortality risk, highlighting the importance of diagnosis and treatment of depression among HIV-infected gay and bisexual men.
American Journal of PsychiatrySevere life stress as a predictor of early disease progression in HIV infection
187 Citations1997Devon Evans, Jane Leserman +12 more
Evidence is presented that severe life event stress is associated with an increased rate of early HIV disease progression, the first evidence from a prospective research study to do so.
International Journal of Behavioral MedicineDistress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus
168 Citations1994Gail Ironson, Andrea Friedman +6 more
It is concluded that distress, denial, and low protocol compliance predict subsequent disease progression in gay men after finding out their HIV serostatus and IIIV-1 disease progression.
JAMADepressive symptoms as predictors of medical outcomes in HIV infection. Multicenter AIDS Cohort Study
168 Citations1993Constantine G. Lyketsos
No evidence is found that depressive symptoms independently prognosticate worse outcomes in HIV infection, and future studies of the relationship between depression and HIV outcome should consider these variables as confounders.
European Journal of CancerPsychoneuroimmunology and cancer: fact or fiction?
159 Citations1999Janice K. Kiecolt‐Glaser, Ronald Glaser
There is substantial evidence from both healthy populations as well as individuals with cancer linking psychological stress with immune downregulation, and the possibility that psychological interventions may enhance immune function and survival among cancer patients clearly merits further exploration.
AIDS Education and PreventionTraumatic Stress in HIV-Infected Women
159 Citations1999Rachel Kimerling, Karen S. Calhoun +6 more
It is concluded that prevention and treatment efforts targeted at HIV-infected women must take into account traumatic stressors and PTSD symptoms and their potential impact on the course of the disease.
Annals of EpidemiologyComorbidity and survival in HIV-Infected men in the San Francisco Men's Health Survey
158 Citations1996Kimberly Page, Gerald N. DeLorenze +2 more
Most chronic and acute concurrent health conditions were not significant discrete predictors of survival to AIDS or death after controlling for immune status and markers of disease progression, but other risk factors (e.g., depression and smoking) were found to be associated with more rapid progression.
Journal of Consulting and Clinical PsychologyCognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men.
137 Citations1998Julienne E. Bower, Margaret E. Kemeny +2 more
Clinical and Diagnostic Laboratory ImmunologyA Bereavement Support Group Intervention Is Longitudinally Associated with Salutary Effects on the CD4 Cell Count and Number of Physician Visits
136 Citations1998Karl Goodkin, Daniel J. Feaster +9 more
The results indicate that behavioral interventions may have salutary immunological and clinical health effects following bereavement among HIV-1-infected individuals and that this bereavement support group intervention might have similarSalutary effects in the general population.
Annals of Behavioral MedicineRelationship of psychosocial factors to HIV disease progression1,2,3
134 Citations1996Thomas L. Patterson, William S. Shaw +6 more
The results provide support for psychoneuroimmunologic effects in HIV, and large social network sizes predicted longevity among those with acquired immune deficiency syndrome (AIDS)-defining symptoms at baseline, but not among other subjects.
Journal of Psychosomatic ResearchActive coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men
126 Citations1992Karl Goodkin, Nancy T. Blaney +8 more
Active coping style was directly and positively associated with NKCC, and trends toward a negative relationship of life stressors and a buffering effect of social support on lives stressors were also observed.
American Journal of PsychiatryRelation of stressors and depressive symptoms to clinical progression of viral illness
125 Citations1996Eric P. Zorrilla, James R. McKay +2 more
Depressive symptoms, but not stressors, increase the risk of HSV recurrence generally and do not appear to accelerate HIV progression ubiquitously, although they are associated with increased reporting of HIV-related symptoms.
Psychosomatic MedicineSocial Support and the Development of Immune Function in Human Immunodeficiency Virus Infection
124 Citations1995Töres Theorell, Vanja Blomkvist +4 more
If the association between a poor AVAT score and rapid CD4 deterioration after HIV infection is replicated in other samples, it could be important to the future clinical care of HIV-infected subjects.
Health PsychologyNegative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men.
115 Citations1999Geoffrey M. Reed, Margaret E. Kemeny +2 more
Negative HIV-specific expectancies predicted the subsequent development of symptoms among bereaved men, controlling for immunological status, use of zidovudine, high-risk sexual behavior, substance use, and depression.
AIDS Education and PreventionEffects of AIDS-Related Bereavement on HIV Progression Among New York City Gay Men
104 Citations1995Margaret E. Kemeny, Laura Dean
The data suggest that bereavement may impact biological systems relevant to HIV progression and that distinguishing specific responses to loss may improve the understanding of these relationships.
American Journal of PsychiatryStress-associated reductions of cytotoxic T lymphocytes and natural killer cells in asymptomatic HIV infection
99 Citations1995Dwight L. Evans, Jane Leserman +8 more
The findings suggest that stress is associated with reductions in killer lymphocytes (decreased NK cell and cytotoxic T lymphocyte phenotypes) in HIV-positive men and indicates that the clinical significance of stress-related changes in cytot toxic T lymphocytes and NK cells in HIV infection warrants further study.
American Journal of PsychiatryStressful life events and symptom onset in HIV infection
97 Citations1991Ronald C. Kessler, Carolyn C. Foster +5 more
There is no need for asymptomatic people with HIV infection to restrict their lives in order to avoid exposure to stressful life experiences or to develop special skills for coping with stress to forestall the progression of HIV illness.
Journal of Psychosomatic ResearchPsychosocial factors and clinical evolution in HIV-1 infection: A longitudinal study
96 Citations1993Luigi Solano, Massimo Costa +5 more
Psychosocial measures most clearly showing an association with clinical evolution were Denial/Repression attitudes and Fighting Spirit, whereas aspects of Hardiness and Social Support showed an effect in interaction with initial CD4+ levels.
Psychosomatic MedicineWhen Children Tell Their Friends They Have AIDS: Possible Consequences for Psychological Well-Being and Disease Progression
85 Citations2000Becky Frink Sherman, George A. Bonanno +2 more
The results were consistent with previous studies showing the positive health consequences of self-disclosure in adults, and suggest potentially important implications for professional and familial care givers of HIV/AIDS individuals.
Journal of Psychosomatic ResearchActive confrontational coping predicts decreased clinical progression over a one-year period in HIV-infected homosexual men
80 Citations1995Cornelis L. Mulder, Michael H. Antoni +3 more
Results show that active coping strategies may have an effect on disease progression, possibly mediated by greater compliance with medical treatments or by psychoneuroimmunological mechanisms.
Health PsychologyCausal attributions predict rate of immune decline in HIV-seropositive gay men.
80 Citations1996Suzanne C. Segerstrom, Shelley E. Taylor +3 more
The results support the idea that causal attributions related to beliefs about the self may have an influence on the immune system and predict faster CD4 decline following an interview.
Psychosomatic MedicineCognitive-behavioral and experiential group psychotherapy for HIV-infected homosexual men: a comparative study.
73 Citations1994Cornelis L. Mulder, Paul M.G. Emmelkamp +4 more
The major finding of this study was that psychosocial intervention, independent of the therapeutic orientation, decreased distress significantly, as compared with a waiting‐list control group (WCG).
The FASEB JournalChemokines activate natural killer cells through heterotrimeric G‐proteins: implications for the treatment of AIDS and cancer
72 Citations1998Azzam A. Maghazachi, A al-Aoukaty
PubMedNatural killer cell responses in homosexual men with early HIV infection.
63 Citations1990Qingxian Cai, Huang Xl +2 more
The results indicate that NK cell function decreases over time within the first 2 years of HIV infection in homosexual men, and is lowest in HIV-seropositive men with overt AIDS.
Clinical Immunology and ImmunopathologyFlow cytometric analysis of γδ T cells and natural killer cells on HIV-1 infection
58 Citations1991Joseph B. Margolick, Elvia R. Scott +2 more
Data suggest that HIV-1 seropositivity is associated with low numbers of natural killer cells and high numbers of CD8+ gamma delta-TCR lymphocytes in homosexual men and intravenous drug users.
AIDS Research and Human RetrovirusesCD16 <sup>+</sup> NK Cells Decrease in All Stages of HIV Infection Through a Selective Depletion of the CD16 <sup>+</sup> CD8 <sup>+</sup> CD3 <sup>-</sup> Subset
57 Citations1990Issam Mansour, C Doînel +1 more
There is a quantitative decrease of the NK CD16- cell population, which appears to be due to a selective depletion of the CD16+CD8+CD3- compartment, and this severe depletion appears to begin early in the infection.
AIDS Research and Human RetrovirusesSelective Depletion of Low-Density CD8 <sup>+</sup> , CD16 <sup>+</sup> Lymphocytes During HIV Infection
55 Citations1988Françoise Vuillier, Nicolás Bianco +2 more
Two color cytofluorometric analyses of CD3-, CD16+, Leu 19+ natural killer cells were assessed in HIV seropositive patients, high-risk seronegative homosexuals, and healthy heterosexuals, finding a selective depletion of lymphocytes bearing NK phenotypes was found among HIV-positive infected patients.
PubMedImmune correlates of stress and depression.
52 Citations1989Dwight L. Evans, Jane Leserman +5 more
There is considerable evidence for an association between a variety of stressful events and lowering immunity and between severe depression and lowered immunity and the clinical relevance of these psychoimmune relationships remains in question.
Annals of Behavioral MedicineSocial relationships and immune processes in HIV seropositive gay and bisexual men
48 Citations1997Gregory E. Miller, Margaret E. Kemeny +3 more
It is revealed that sexual behavior, medication use, bereavement, coping, and a number of other variables were not mechanisms through which loneliness affected the immune system.
Behavioral MedicineDisease Progression in HIV-Positive Women With Moderate to Severe Immunosuppression: The Role of Depression
39 Citations1999Kavita Vedhara, Giovanni Schifitto +1 more
It is concluded that depression may not be a significant determinant of disease progression in women with advanced disease and called for further investigations with larger samples and women at earlier stages of the infection.
Health PsychologyAvoidance as a predictor of the biological course of HIV infection over a 7-year period in gay men.
38 Citations1999Cornelis L. Mulder, E.M.M. de Vroome +3 more
Findings revealed that for a number of medical and behavioral factors, avoidance coping predicted a lower rate of decline in CD4 cells, and the proportional hazard attributable to avoidance of developing a syncytium-inducing HIV variant was 0.72.
Journal of Epidemiology & Community HealthHIV infection: social network, social support, and CD4 lymphocyte values in infected homosexual men in Malmö, Sweden.
38 Citations1994Rebecca Gagnemo Persson, Bo Gullberg +3 more
These results, if reproduced in a longitudinal study, might suggest that psychosocial factors can affect an individual's immune system.
Psychology and HealthThe relationship between loneliness, interpersonal competence, and immunologic status in hiv-infected men
36 Citations1994Kristy Straits-Tröster, Thomas L. Patterson +6 more
Among seropositive men, loneliness was negatively correlated with self-perceived competence in all five relationship domains assessed: initiation of social interactions, self-disclosure, providing emotional support to others, and conflict management.
American Journal of PsychiatryPsychological distress and natural killer cells in gay men with and without HIV infection
30 Citations1994John Sahs, Raymond R. Goetz +5 more
NK cell number is not related to measures of psychological distress in these gay men with and without HIV infection.
Clinical Psychology & PsychotherapyCoping responses to HIV‐1 serostatus notification predict concurrent and prospective immunologic status
29 Citations1995Michael H. Antoni, David Goldstein +4 more
Preliminary findings suggested that coping strategies relate to immunologic status differentially for infected and non-infected risk group members; strategies that distract seropositive individuals from the stress of infectivity are related to more impairment on some immunologic markers.
Clinical & Experimental ImmunologyEvidence for circulating activated cytotoxic T cells in HIV-infected subjects before the onset of opportunistic infections
29 Citations1990Guido Vanham, Luc Kestens +5 more
The data show that circulating CD8+HLA‐DR+ CTJ57+ T cells in HIV+ subjects are activated cytotoxic T cells and point to progressive (over) activation of this T cell compartment until the onset of opportunistic infections.
The Journal of Infectious DiseasesCD8<sup>+</sup>Cell‐Derived Anti–Human Immunodeficiency Virus Inhibitory Factor
27 Citations1999Edward Barker
The ability of CD8+ cells to produce CAF and suppress HIV replication plays a critical role in preventing disease progression following HIV infection.
JAMADepression and Survival Among HIV-Infected Persons
27 Citations1996Constantine G. Lyketsos
Changes in severity of depression, at a time of multiple psychological and biological stressors, raises the question as to whether depression at later stages of HIV infection is different from depression at earlier stages.
Behavioral MedicineHigh Versus Low Basal Cortisol Secretion in Asymptomatic, Medication-free HIV-infected Men: Differential Effects of Severe Life Stress on Parameters of Immune Status
23 Citations2000John M. Petitto, Jane Leserman +8 more
It is suggested that severe stress in combination with high glucocorticoid activity may modify select parameters of immune status in HIV-infected men.
PubMedCD8 lymphocytes in HIV infection: helpful and harmful.
19 Citations1997Giuseppe Famularo, Sonia Moretti +3 more
It is likely that early during the course of HIV infection when viral loads are generally low an efficient CD8 cell response can control HIV replication whereas in subjects with evolving disease, who have very high viral loads, CD8 lymphocytes remove essential components of the immune response and mediate tissue injury.
Clinical ScienceCytotoxic T lymphocytes and viral evolution in primary HIV-1 infection
14 Citations1999David A. Price, Christopher A. O’Callaghan +3 more
Acta Psychiatrica ScandinavicaAre immunological markers, social and personal resources, or a complaint‐free state predictors of progression among HIV‐infected patients?
9 Citations1997Dominique Eich‐Höchli, Matthias Niklowitz +2 more
In the multivariate analyses, the baseline CD4 count was the only significant predictor of disease progression during both observation periods and psychosocial measures did not predict the progression of HIV infection.
JAMAHeat-Related Illnesses and Deaths—Missouri, 1998, and United States, 1979-1996
8 Citations1999
Four heat-related deaths that occurred in Missouri during 1998 are described, risk factors associated withHeat-related illness and death, especially in susceptible populations (young and elderly, chronically ill, and disabled persons), are describes, and preventive measures are recommended.
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