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Am J Psychiatry 1991; 148:41-45
Copyright © 1991 by American Psychiatric Association
Glucocorticoid level and neuropsychiatric symptoms in homosexual men with HIV infection
JM Gorman, R Kertzner, T Cooper, RR Goetz, I Lagomasino, H Novacenko, JB Williams, Y Stern, R Mayeux and AA Ehrhardt
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, NY.
OBJECTIVE: There is a controversial literature suggesting that stress,
anxiety, and depression are harmful to the immune system and therefore to
health. Preclinical studies indicate that activation of the
hypothalamic-pituitary-adrenal (HPA) axis by stress may be responsible for
immunocompromise. The goal of this study was to assess this phenomenon in
human immunodeficiency virus (HIV) infection. METHOD: Homosexual men in the
community who did not meet modified Centers for Disease Control criteria
for acquired immune deficiency syndrome (AIDS) were recruited for the
study; 113 of the men were HIV positive and 77 were HIV negative. Very few
of the men studied suffered from depression or anxiety disorder at the time
of the first assessment. Twenty-four- hour urinary free cortisol levels
were obtained from the 112 HIV- positive and 75 HIV-negative men whose
24-hour urine volumes were 500 ml or more. Cortisol levels were correlated
with measures of medical, immunological, neurological, and psychiatric
status. RESULTS: Small but significant correlations between 24-hour urinary
free cortisol and medical status, level of depression, and level of anxiety
were found in the HIV-positive group. There was no relationship between
cortisol level and the number of CD4+ or CD8+ T lymphocytes or the CD4-CD8
ratio. CONCLUSIONS: Although HPA activation may be associated with stress
in cases of HIV infection, it does not seem to be associated with further
loss of CD4+ T lymphocytes. Subjects with HIV infection with the most
evidence of medical complications may also be the most anxious and
depressed.
This article has been cited by other articles:
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