title: Do Alcohol Misuse, Smoking, and Depression Vary Concordantly or Sequentially? A Longitudinal Study of HIV-Infected and Matched Uninfected Veterans in Care.
abstract: We analyzed temporal patterns of alcohol misuse, smoking, and depression among veterans in care to determine whether these conditions vary concordantly or sequentially. Using the Veterans Aging Cohort Study, harmful alcohol use (AUDIT-C ≥ 4), current smoking, and depression (PHQ-9 ≥ 8), were measured. In regression analyses, predictors included each outcome condition at baseline, the other two conditions in the same survey, the other two conditions in the immediately preceding survey, number of years since enrollment, and HIV status. We found that current smoking and depression were more common among HIV infected individuals. Harmful alcohol use was more common among uninfected individuals. Temporal analyses suggested a concurrent pattern: each condition was associated with the other two conditions (p < 0.03, OR 1.12-1.66) as well as with the prior presence of the same condition (p < 0.0001; OR 6.38-22.02). Smoking was associated with prior depression after controlling for current depression (OR 1.16; p = 0.003). In conclusion, alcohol misuse, smoking, and depression were temporally concordant and persistent, raising the question of whether they constitute a common syndrome in HIV infected patients and others with chronic diseases.
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6 Room 615, New York, NY, 10016, USA. Scott.Braithwaite@nyumc.org.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Braithwaite
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6 Room 615, New York, NY, 10016, USA.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Tate
authors.affiliation: Department of Population Health, New York University School of Medicine, 227 East 30th Street, Floor 6 Room 615, New York, NY, 10016, USA.
authors.forename: Sherry M
authors.initials: SM
authors.lastname: Mentor
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bryant
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Aging; Alcohol use; Depression; HIV; Smoking; Temporal analysis; Veterans