title: The impact of alcohol use on depressive symptoms in human immunodeficiency virus-infected patients.
abstract: 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.
authors.affiliation: Yale University School of Medicine, 367 Cedar Street, New Haven, CT 06520, USA. lynn.sullivan@yale.edu
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Howard
authors.initials: H
authors.lastname: Libman
authors.forename: David
authors.initials: D
authors.lastname: Nunes
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: 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