Optimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men

Nicole M. Armstrong, Pamela Surkan, Glenn Jordan Treisman, Ned Sacktor, Michael R. Irwin, Linda A. Teplin, Ron C. Stall, Lisa Paula Jacobson, Alison Gump Abraham

Research output: Contribution to journalArticle

Abstract

Objectives: Center of Epidemiologic Studies–Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear. Method: To identify long-term depression among HIV-infected and HIV–uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D–based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics. Results: A positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1%) and HIV-uninfected MSM (prevalence = 23.2%). Compared to the depressive phenotype, trajectory models of CES-D≥20 provided highest specificities among HIV-infected (specificity = 99.9%, 95% Confidence Interval [CI]:99.4%–100.0%) and HIV-uninfected MSM (specificity = 99.0%, 95% CI:97.4%–99.7%). Highest sensitivities resulted from classifying baseline CES-D ≥ 16 among HIV-infected MSM (sensitivity = 75.0%, 95% CI:67.3%–81.7%) and four consecutive CES-Ds ≥ 16 among HIV-uninfected MSM (sensitivity = 81.0%, 95% CI:73.7%–87.0%). Conclusion: Choice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAging and Mental Health
DOIs
StateAccepted/In press - Feb 1 2018

Fingerprint

HIV
Confidence Intervals
Phenotype
History
Demography
Sensitivity and Specificity
Pharmaceutical Preparations

Keywords

  • Depression
  • HIV infection
  • sensitivity
  • specificity
  • validity

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

@article{fd8f80b33d814ae985f68f27a838b0aa,
title = "Optimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men",
abstract = "Objectives: Center of Epidemiologic Studies–Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear. Method: To identify long-term depression among HIV-infected and HIV–uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D–based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics. Results: A positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1{\%}) and HIV-uninfected MSM (prevalence = 23.2{\%}). Compared to the depressive phenotype, trajectory models of CES-D≥20 provided highest specificities among HIV-infected (specificity = 99.9{\%}, 95{\%} Confidence Interval [CI]:99.4{\%}–100.0{\%}) and HIV-uninfected MSM (specificity = 99.0{\%}, 95{\%} CI:97.4{\%}–99.7{\%}). Highest sensitivities resulted from classifying baseline CES-D ≥ 16 among HIV-infected MSM (sensitivity = 75.0{\%}, 95{\%} CI:67.3{\%}–81.7{\%}) and four consecutive CES-Ds ≥ 16 among HIV-uninfected MSM (sensitivity = 81.0{\%}, 95{\%} CI:73.7{\%}–87.0{\%}). Conclusion: Choice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.",
keywords = "Depression, HIV infection, sensitivity, specificity, validity",
author = "Armstrong, {Nicole M.} and Pamela Surkan and Treisman, {Glenn Jordan} and Ned Sacktor and Irwin, {Michael R.} and Teplin, {Linda A.} and Stall, {Ron C.} and Jacobson, {Lisa Paula} and Abraham, {Alison Gump}",
year = "2018",
month = "2",
day = "1",
doi = "10.1080/13607863.2017.1423037",
language = "English (US)",
pages = "1--8",
journal = "Aging and Mental Health",
issn = "1360-7863",
publisher = "Taylor and Francis Ltd.",

}

TY - JOUR

T1 - Optimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men

AU - Armstrong, Nicole M.

AU - Surkan, Pamela

AU - Treisman, Glenn Jordan

AU - Sacktor, Ned

AU - Irwin, Michael R.

AU - Teplin, Linda A.

AU - Stall, Ron C.

AU - Jacobson, Lisa Paula

AU - Abraham, Alison Gump

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objectives: Center of Epidemiologic Studies–Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear. Method: To identify long-term depression among HIV-infected and HIV–uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D–based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics. Results: A positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1%) and HIV-uninfected MSM (prevalence = 23.2%). Compared to the depressive phenotype, trajectory models of CES-D≥20 provided highest specificities among HIV-infected (specificity = 99.9%, 95% Confidence Interval [CI]:99.4%–100.0%) and HIV-uninfected MSM (specificity = 99.0%, 95% CI:97.4%–99.7%). Highest sensitivities resulted from classifying baseline CES-D ≥ 16 among HIV-infected MSM (sensitivity = 75.0%, 95% CI:67.3%–81.7%) and four consecutive CES-Ds ≥ 16 among HIV-uninfected MSM (sensitivity = 81.0%, 95% CI:73.7%–87.0%). Conclusion: Choice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.

AB - Objectives: Center of Epidemiologic Studies–Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear. Method: To identify long-term depression among HIV-infected and HIV–uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D–based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics. Results: A positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1%) and HIV-uninfected MSM (prevalence = 23.2%). Compared to the depressive phenotype, trajectory models of CES-D≥20 provided highest specificities among HIV-infected (specificity = 99.9%, 95% Confidence Interval [CI]:99.4%–100.0%) and HIV-uninfected MSM (specificity = 99.0%, 95% CI:97.4%–99.7%). Highest sensitivities resulted from classifying baseline CES-D ≥ 16 among HIV-infected MSM (sensitivity = 75.0%, 95% CI:67.3%–81.7%) and four consecutive CES-Ds ≥ 16 among HIV-uninfected MSM (sensitivity = 81.0%, 95% CI:73.7%–87.0%). Conclusion: Choice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.

KW - Depression

KW - HIV infection

KW - sensitivity

KW - specificity

KW - validity

UR - http://www.scopus.com/inward/record.url?scp=85041858318&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041858318&partnerID=8YFLogxK

U2 - 10.1080/13607863.2017.1423037

DO - 10.1080/13607863.2017.1423037

M3 - Article

SP - 1

EP - 8

JO - Aging and Mental Health

JF - Aging and Mental Health

SN - 1360-7863

ER -