title: Cocaine Use May be Associated with Increased Depression in Persons Infected with HIV.
abstract: HIV infection, depression, and cocaine use are independently associated with increased inflammatory signal production. There is increasing evidence about the role of inflammation in depression. In HIV disease, cocaine use may increase disease progression as well as alter T cell functioning resulting in cytokine activation and thereby increasing susceptibility to depression. We examined the association between cocaine use and depression among 447 African American persons infected with HIV who were frequent cocaine users or non-users, enrolled in an observational study in Baltimore, Maryland, between August 2003 and December 2012. The overall prevalence of depression was 40.9 % (183 of 447) participants. Among persons who were depressed, the prevalence of cocaine use was 81.4 % (149 of 183), compared to 69.3 % among persons who were not depressed (183 of 264), P = 0.004. Cocaine use was associated with nearly twofold increased odds of depression, unadjusted odds ratio (OR) 1.94, (95 % CI 1.23, 3.06); P = 0.004, compared to never using cocaine, and OR 1.02, (95 % CI 1.10, 1.05); P = 0.04 in adjusted analysis. A dose-response relationship between increasing duration of cocaine use and depression was observed. Frequency and duration of cocaine use may be associated with depression. We speculate that depression among cocaine users with HIV may involve an inflammatory component that needs further examination.
authors.affiliation: Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Meyer 119 Psychiatry, 600 North Wolfe Street, Baltimore, MD, 21287 7119, USA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Hammond
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Shenghan
authors.initials: S
authors.lastname: Lai
authors.affiliation: Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Meyer 119 Psychiatry, 600 North Wolfe Street, Baltimore, MD, 21287 7119, USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Wright
authors.affiliation: Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Meyer 119 Psychiatry, 600 North Wolfe Street, Baltimore, MD, 21287 7119, USA. glenn@jhmi.edu.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Treisman
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015142:Baltimore / Q000453:epidemiology; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000523:psychology; D003324:Coronary Artery Disease / Q000139:chemically induced; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D055030:Drug Users / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence
chemical_list: D019380:Anti-HIV Agents
keywords: Cocaine; Depression; HIV; Mental health