Lipoatrophy among HIV‐infected patients is associated with higher levels of depression than lipohypertrophy

Abstract
Objectives We sought to determine the association between body morphology abnormalities and depression, examining lipoatrophy and lipohypertrophy separately. Methods An observational cross‐sectional study of 250 patients from the University of Washington HIV Cohort was carried out. Patients completed an assessment including measures of depression and body morphology. We used linear regression analysis to examine the association between lipoatrophy or lipohypertrophy and depression. Analysis of variance was used to examine the relationship between mean depression scores and lipoatrophy and lipohypertrophy in 10 body regions. Results Of 250 patients, 76 had lipoatrophy and 128 had lipohypertrophy. Mean depression scores were highest among patients with moderate‐to‐severe lipoatrophy (16.4), intermediate among those with moderate‐to‐severe lipohypertrophy (11.7), mild lipohypertrophy (9.9) and mild lipoatrophy (8.5), and lowest among those without body morphology abnormalities (7.7) (P=0.002). After adjustment, mean depression scores for subjects reporting moderate‐to‐severe lipoatrophy were 9.2 points higher (PP=0.02), and scores for subjects with mild lipohypertrophy were 2.8 points higher (P=0.03) than those for patients without body morphology abnormalities. Facial lipoatrophy was the body region associated with the most severe depression scores (15.5 vs. 8.9 for controls; P=0.03). Conclusions In addition to long‐term cardiovascular implications, body morphology has a more immediate effect on depression severity.