title: Religion, spirituality, and depressive symptoms in patients with HIV/AIDS.
abstract: BACKGROUND
  Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well-being has been linked to increased risk for depression and other mood disorders in patients with HIV.
  
  
  OBJECTIVE
  We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi-center cohort of patients with HIV/AIDS.
  
  
  METHODS
  Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale. Independent variables included socio-demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self-esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms.
  
  
  RESULTS
  We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty-one (53.6%) fit the criteria for significant depressive symptoms (CESD-10 score > or = 10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV-related symptoms, less social support, and lower spiritual well-being was associated with significant depressive symptoms (P<.05).
  
  
  CONCLUSIONS
  A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well-being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.
authors.affiliation: Division of General Internal Medicine, Section of Outcomes Research, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267-0535, USA. michael.yi@uc.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Yi
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mrus
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Wade
authors.forename: Mona L
authors.initials: ML
authors.lastname: Ho
authors.forename: Richard W
authors.initials: RW
authors.lastname: Hornung
authors.forename: Sian
authors.initials: S
authors.lastname: Cotton
authors.forename: Amy H
authors.initials: AH
authors.lastname: Peterman
authors.forename: Christina M
authors.initials: CM
authors.lastname: Puchalski
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D017533:Marital Status; D015999:Multivariate Analysis; D015995:Prevalence; D012069:Religion and Psychology; D014481:United States / Q000453:epidemiology