Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV
PURPOSE:Substance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH. METHODS:Data are from PLWH enrolled in the...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2018-11, Vol.79 (3), p.283-287 |
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| creator | Delaney, Joseph A Nance, Robin M Whitney, Bridget M Altice, Frederick L Dong, Xinyuan Trejo, Maria Esther Perez Matsuzaki, Mika Taxman, Faye S Chander, Geetanjali Kuo, Irene Fredericksen, Rob Strand, Lauren N Eron, Joseph J Geng, Elvin Kitahata, Mari M Mathews, William C Mayer, Kenneth Moore, Richard D Saag, Michael S Springer, Sandra Chandler, Redonna Kahana, Shoshana Crane, Heidi M |
| description | PURPOSE:Substance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH.
METHODS:Data are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.
RESULTS:Among 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptomsstopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.
CONCLUSIONS:We demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time. |
| doi_str_mv | 10.1097/QAI.0000000000001803 |
| format | Article |
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METHODS:Data are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.
RESULTS:Among 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptomsstopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.
CONCLUSIONS:We demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000001803</identifier><identifier>PMID: 30036277</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Abstinence ; Acquired immune deficiency syndrome ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; AIDS ; Amphetamines ; Cannabis ; Cocaine ; Depression - pathology ; Drug abuse ; Drug use ; Drug Utilization - statistics & numerical data ; Female ; HIV ; HIV Infections - complications ; Human immunodeficiency virus ; Humans ; Illicit Drugs - adverse effects ; Impact analysis ; Longitudinal Studies ; Male ; Marijuana ; Mental depression ; Mental disorders ; Mental health ; Middle Aged ; Narcotics ; Opioids ; Substance use ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2018-11, Vol.79 (3), p.283-287</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Ovid Technologies Nov 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2753-8e7e2bc81ecbc53717b50c4e0e8c2947f5150957832e67f61683bf0e075473903</citedby><cites>FETCH-LOGICAL-c2753-8e7e2bc81ecbc53717b50c4e0e8c2947f5150957832e67f61683bf0e075473903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30036277$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Delaney, Joseph A</creatorcontrib><creatorcontrib>Nance, Robin M</creatorcontrib><creatorcontrib>Whitney, Bridget M</creatorcontrib><creatorcontrib>Altice, Frederick L</creatorcontrib><creatorcontrib>Dong, Xinyuan</creatorcontrib><creatorcontrib>Trejo, Maria Esther Perez</creatorcontrib><creatorcontrib>Matsuzaki, Mika</creatorcontrib><creatorcontrib>Taxman, Faye S</creatorcontrib><creatorcontrib>Chander, Geetanjali</creatorcontrib><creatorcontrib>Kuo, Irene</creatorcontrib><creatorcontrib>Fredericksen, Rob</creatorcontrib><creatorcontrib>Strand, Lauren N</creatorcontrib><creatorcontrib>Eron, Joseph J</creatorcontrib><creatorcontrib>Geng, Elvin</creatorcontrib><creatorcontrib>Kitahata, Mari M</creatorcontrib><creatorcontrib>Mathews, William C</creatorcontrib><creatorcontrib>Mayer, Kenneth</creatorcontrib><creatorcontrib>Moore, Richard D</creatorcontrib><creatorcontrib>Saag, Michael S</creatorcontrib><creatorcontrib>Springer, Sandra</creatorcontrib><creatorcontrib>Chandler, Redonna</creatorcontrib><creatorcontrib>Kahana, Shoshana</creatorcontrib><creatorcontrib>Crane, Heidi M</creatorcontrib><title>Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>PURPOSE:Substance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH.
METHODS:Data are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.
RESULTS:Among 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptomsstopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.
CONCLUSIONS:We demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time.</description><subject>Abstinence</subject><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>AIDS</subject><subject>Amphetamines</subject><subject>Cannabis</subject><subject>Cocaine</subject><subject>Depression - pathology</subject><subject>Drug abuse</subject><subject>Drug use</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Illicit Drugs - adverse effects</subject><subject>Impact analysis</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Marijuana</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>Substance use</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1O3DAUha2qqPz1DRCy1C0BO7Zju7spUIg0EhRKu4wSzw1jmsSp7QziRfq8GAZQ1UW9ub72d46texDao-SQEi2Pvs3KQ_LXooqwd2iLas4zqRR_n_YiFxmnTGyi7RDuElNwrj-gTUYIK3Ipt9CfL95Ci69gdD5-TnUxGVjgmwDYtbjsOmtsxNdTE2I9GAgH-HQFA_5p49JNEc_SuR0g3RzgMuBZCM7YOiaHJwKX_ejdKnUnMHoIwa4AXz_0Y3R9gns33OJLcGMHeG5XNnXPqvPyxy7aaOsuwMeXuoNuvp5-Pz7P5hdn5fFsnplcCpYpkJA3RlEwjRFMUtkIYjgQUCbXXLaCCqKFVCyHQrYFLRRrWgJECi6ZJmwHfVr7pn_-niDE6s5NfkhPVjnNtU7DVDpRfE0Z70Lw0Fajt33tHypKqqcwqhRG9W8YSbb_Yj41PSzeRK_TT4BaA_eui-DDr266B18toe7i8v_ej_AslTg</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Delaney, Joseph A</creator><creator>Nance, Robin M</creator><creator>Whitney, Bridget M</creator><creator>Altice, Frederick L</creator><creator>Dong, Xinyuan</creator><creator>Trejo, Maria Esther Perez</creator><creator>Matsuzaki, Mika</creator><creator>Taxman, Faye S</creator><creator>Chander, Geetanjali</creator><creator>Kuo, Irene</creator><creator>Fredericksen, Rob</creator><creator>Strand, Lauren N</creator><creator>Eron, Joseph J</creator><creator>Geng, Elvin</creator><creator>Kitahata, Mari M</creator><creator>Mathews, William C</creator><creator>Mayer, Kenneth</creator><creator>Moore, Richard D</creator><creator>Saag, Michael S</creator><creator>Springer, Sandra</creator><creator>Chandler, Redonna</creator><creator>Kahana, Shoshana</creator><creator>Crane, Heidi M</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>20181101</creationdate><title>Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV</title><author>Delaney, Joseph A ; Nance, Robin M ; Whitney, Bridget M ; Altice, Frederick L ; Dong, Xinyuan ; Trejo, Maria Esther Perez ; Matsuzaki, Mika ; Taxman, Faye S ; Chander, Geetanjali ; Kuo, Irene ; Fredericksen, Rob ; Strand, Lauren N ; Eron, Joseph J ; Geng, Elvin ; Kitahata, Mari M ; Mathews, William C ; Mayer, Kenneth ; Moore, Richard D ; Saag, Michael S ; Springer, Sandra ; Chandler, Redonna ; Kahana, Shoshana ; Crane, Heidi M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2753-8e7e2bc81ecbc53717b50c4e0e8c2947f5150957832e67f61683bf0e075473903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abstinence</topic><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>AIDS</topic><topic>Amphetamines</topic><topic>Cannabis</topic><topic>Cocaine</topic><topic>Depression - pathology</topic><topic>Drug abuse</topic><topic>Drug use</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Illicit Drugs - adverse effects</topic><topic>Impact analysis</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Marijuana</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Narcotics</topic><topic>Opioids</topic><topic>Substance use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Delaney, Joseph A</creatorcontrib><creatorcontrib>Nance, Robin M</creatorcontrib><creatorcontrib>Whitney, Bridget M</creatorcontrib><creatorcontrib>Altice, Frederick L</creatorcontrib><creatorcontrib>Dong, Xinyuan</creatorcontrib><creatorcontrib>Trejo, Maria Esther Perez</creatorcontrib><creatorcontrib>Matsuzaki, Mika</creatorcontrib><creatorcontrib>Taxman, Faye S</creatorcontrib><creatorcontrib>Chander, Geetanjali</creatorcontrib><creatorcontrib>Kuo, Irene</creatorcontrib><creatorcontrib>Fredericksen, Rob</creatorcontrib><creatorcontrib>Strand, Lauren N</creatorcontrib><creatorcontrib>Eron, Joseph J</creatorcontrib><creatorcontrib>Geng, Elvin</creatorcontrib><creatorcontrib>Kitahata, Mari M</creatorcontrib><creatorcontrib>Mathews, William C</creatorcontrib><creatorcontrib>Mayer, Kenneth</creatorcontrib><creatorcontrib>Moore, Richard D</creatorcontrib><creatorcontrib>Saag, Michael S</creatorcontrib><creatorcontrib>Springer, Sandra</creatorcontrib><creatorcontrib>Chandler, Redonna</creatorcontrib><creatorcontrib>Kahana, Shoshana</creatorcontrib><creatorcontrib>Crane, Heidi M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Delaney, Joseph A</au><au>Nance, Robin M</au><au>Whitney, Bridget M</au><au>Altice, Frederick L</au><au>Dong, Xinyuan</au><au>Trejo, Maria Esther Perez</au><au>Matsuzaki, Mika</au><au>Taxman, Faye S</au><au>Chander, Geetanjali</au><au>Kuo, Irene</au><au>Fredericksen, Rob</au><au>Strand, Lauren N</au><au>Eron, Joseph J</au><au>Geng, Elvin</au><au>Kitahata, Mari M</au><au>Mathews, William C</au><au>Mayer, Kenneth</au><au>Moore, Richard D</au><au>Saag, Michael S</au><au>Springer, Sandra</au><au>Chandler, Redonna</au><au>Kahana, Shoshana</au><au>Crane, Heidi M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>79</volume><issue>3</issue><spage>283</spage><epage>287</epage><pages>283-287</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>PURPOSE:Substance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH.
METHODS:Data are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.
RESULTS:Among 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptomsstopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.
CONCLUSIONS:We demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>30036277</pmid><doi>10.1097/QAI.0000000000001803</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abstinence Acquired immune deficiency syndrome Adolescent Adult Aged Aged, 80 and over AIDS Amphetamines Cannabis Cocaine Depression - pathology Drug abuse Drug use Drug Utilization - statistics & numerical data Female HIV HIV Infections - complications Human immunodeficiency virus Humans Illicit Drugs - adverse effects Impact analysis Longitudinal Studies Male Marijuana Mental depression Mental disorders Mental health Middle Aged Narcotics Opioids Substance use Young Adult |
| title | Brief Report: Reduced Use of Illicit Substances, Even Without Abstinence, Is Associated With Improved Depressive Symptoms Among People Living With HIV |
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