Depression care and prevalence in HIV-positive individuals
Raymond L Ownby1, Robin J Jacobs1, Drenna Waldrop-Valverde2, Felicia Gould2
1Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA; 2Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
Abstract: Depression is among the most common neuropsychiatric disturbances seen in individuals with HIV infection. Associated with sad mood, disturbed sleep and appetite, and low energy, the symptoms of depression may be difficult to distinguish from those of the infection itself. Depression has enormous clinical significance in this group of patients, not only for the misery and poor quality of life it causes but also for its negative effect on patients’ sexual risk behavior, substance use, and medication adherence. Depression has been associated with patients’ immune system functioning and with poorer disease outcomes. Although it can be effectively treated in most individuals, fewer than one half of patients with depression are correctly diagnosed and still fewer receive adequate treatment. Effective treatments for depression in this group include antidepressant medication, individual and group psychotherapy, and social support interventions. Given the significance of this common yet under-recognized problem, clinicians should be aware of the implications of failing to aggressively treat depression in HIV-infected individuals.
Keywords: HIV, depression, SSRI, cognitive-behavioral therapy, neuroinflammation, stigma
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