Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS).
OBJECTIVE
We studied the incidence and prevalence of, and co-factors for depression in the Swiss HIV Cohort Study.


METHODS
Depression-specific items were introduced in 2010 and prospectively collected at semiannual cohort visits. Clinical, laboratory and behavioral co-factors of incident depression among participants free of depression at the first two visits in 2010 or thereafter were analyzed with Poisson regression. Cumulative prevalence of depression at the last visit was analyzed with logistic regression.


RESULTS
Among 4,422 participants without a history of psychiatric disorders or depression at baseline, 360 developed depression during 9,348 person-years (PY) of follow-up, resulting in an incidence rate of 3.9 per 100 PY (95% confidence interval (CI) 3.5-4.3). Cumulative prevalence of depression during follow-up was recorded for 1,937/6,756 (28.7%) participants. Incidence and cumulative prevalence were higher in injection drug users (IDU) and women. Older age, preserved work ability and higher physical activity were associated with less depression episodes. Mortality (0.96 per 100 PY, 95% CI 0.83-1.11) based upon 193 deaths over 20,102 PY was higher among male IDU (2.34, 1.78-3.09), female IDU (2.33, 1.59-3.39) and white heterosexual men (1.32, 0.94-1.84) compared to white heterosexual women and homosexual men (0.53, 0.29-0.95; and 0.71, 0.55-0.92). Compared to participants free of depression, mortality was slightly elevated among participants with a history of depression (1.17, 0.94-1.45 vs. 0.86, 0.71-1.03, P = 0.033). Suicides (n = 18) did not differ between HIV transmission groups (P = 0.50), but were more frequent among participants with a prior diagnosis of depression (0.18 per 100 PY, 95%CI 0.10-0.31; vs. 0.04, 0.02-0.10; P = 0.003).


CONCLUSIONS
Depression is a frequent co-morbidity among HIV-infected persons, and thus an important focus of care.
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Alexia
A
Anagnostopoulos
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Bruno
B
Ledergerber
Independent Researcher, HIV Practitioner, Zurich, Switzerland.
René
R
Jaccard
Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Susy Ann
SA
Shaw
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
Marcel
M
Stoeckle
Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland.
Enos
E
Bernasconi
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Jürgen
J
Barth
Division of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland.
Alexandra
A
Calmy
Psychiatry Liaison Service, Lausanne University Hospital, Lausanne, Switzerland.
Alexandre
A
Berney
Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Zurich, Switzerland.
Josef
J
Jenewein
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Rainer
R
Weber
D003863:Depression / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology