The impact of alcohol use on depressive symptoms in human immunodeficiency virus-infected patients.
OBJECTIVE
To examine the impact of alcohol use on depressive symptoms in human immunodeficiency virus (HIV)-infected patients.


METHODS
Data were collected at 6-month intervals and analyzed to evaluate the association between alcohol dependence and consumption on depressive symptoms using longitudinal mixed-effects regression models controlling for specified covariates.


METHODS
The two independent variables were current alcohol dependence assessed using the Composite International Diagnostic Interview (CIDI) and past month consumption (heavy versus not heavy drinking) using a validated calendar-based method. The primary outcome was depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D).


METHODS
HIV-infected adults with current or past alcohol problems.


RESULTS
Alcohol dependence and heavy alcohol use were significantly associated with higher CES-D scores in unadjusted models. In adjusted analyses, the association of current alcohol dependence persisted [mean difference in CES-D was 3.49 for dependence versus non-dependence; 95% confidence interval (CI): 1.76-5.22]; however, the effect of heavy drinking was no longer statistically significant (mean difference in CES-D was 1.04 for heavy versus not heavy drinking; 95% CI: -0.24-2.32).


CONCLUSIONS
Alcohol use is associated with more depressive symptoms in HIV-infected patients with alcohol problems. This association remains significant after adjusting for potential confounders only when alcohol use meets the criteria for alcohol dependence.
Sullivan
Lynn E
LE
Yale University School of Medicine, 367 Cedar Street, New Haven, CT 06520, USA. lynn.sullivan@yale.edu
Saitz
Richard
R
Cheng
Debbie M
DM
Libman
Howard
H
Nunes
David
D
Samet
Jeffrey H
JH
D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales