Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

Depression is the most common neuropsychiatric complication in HIV-infected patients and may occur in all phases of the infection. Accurately, diagnosing major depressive disorder in the context of HIV is an ongoing challenge to clinicians and researchers, being complicated by the complex biological, psychological, and social factors associated with the HIV illness. Evidences exist to support the importance of improving the identification of depressive symptoms and their adequate treatment. Depression has long been recognized as a predictor of negative clinical outcomes in HIV-infected patients, such as reducing medication adherence, quality of life, and treatment outcome, and possibly worsening the progression of the illness and increasing mortality. By analyzing the most relevant studies (MEDLINE, EMBASE, PsycLit, Cochrane Library), the review discusses the epidemiology and the main clinical features of depression in HIV-infected patients, the causal pathways linking depression and HIV infection, the validity of screening tools, and the efficacy of different treatment approaches, including psychosocial interventions, psychopharmacology as well as HIV-specific health psychology health service models.

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Depression in HIV Infected Patients: a Review

Nanni

Caruso

Mitchell

et al. 2014

Curr Psychiatry Rep

386

281

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Prevalence, impact, and management of depression and anxiety in patients with HIV: a review

Bakhla¹,

Saini²

2016

NBHIV

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The prevalence of depression and anxiety in people living with HIV/AIDS (PLWHA) ranges from 7.2% to 71.9% and 4.5% to 82.3%, respectively. This wide variation is attributed to differences in sample size and characteristics, and methodology for assessment of anxiety and depression. Moreover, anxiety and depression increase the morbidity of HIV by poor adherence to treatment and various other significant mechanisms. Early identification and effective management of these disorders is associated with improved antiretroviral adherence and improved quality of life in PLWHA. Different treatment modalities, including pharmacological and nonpharmacological therapies, are used for the management of anxiety and depression in PLWHA. Benzodiazepines are indicated for short periods of time. Clonazepam and lorazepam are safe in terms of drug-drug interactions and may be preferred. Selective serotonin reuptake inhibitors are safer than tricyclic antidepressants. Though the different selective serotonin reuptake inhibitors are supposed to be equally effective, to avoid interactions with antiretrovirals, the better options are sertraline, citalopram, and escitalopram. Various nonpharmacological therapies, including cognitive behavior therapy, interpersonal therapy, supportive psychotherapy, cognitive-behavioral-oriented group psychotherapy, experiential group psychotherapy, cognitive-behavioral stress management, stress management interventions, cognitive remediation therapy, mindfulness-based therapy, and aerobic and resistance exercise have been reported to be useful in treating depression among PLWHA. However, definitive evidence to decide which nonpharmacological intervention is most beneficial for the management of anxiety and depression in PLWHA is still required.

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Psychiatric morbidity among human immunodeficiency virus test seekers attending the integrated counseling and testing center facility of a tertiary care hospital in South India

Nagarajan¹,

Chelladurai²,

Menon³

et al. 2022

Industrial Psychiatry Journal

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Background: Testing for human immunodeficiency virus (HIV) infection has become a mandatory and routine regimen for various reasons. Literature suggests that the level of psychiatric morbidity is high among HIV-infected individuals. However, often psychiatric problems are undetected and untreated among these people and this is possible by the simple measure of screening when these people contact a health-care facility such as an integrated counseling and testing center (ICTC). The paucity of published data in this arena necessitates exploring the facts related to this issue. Hence, this study was aimed to identify the psychiatric morbidity among people undergoing HIV testing by a screening method. Methods: A cross-sectional, descriptive study was carried out among 384 individuals, those who were undergoing HIV testing at an ICTC facility of a tertiary care hospital in South India. They were assessed for psychiatric morbidity by a structured clinical diagnostic interview using mini international neuropsychiatric interview. Those people who were identified as having psychiatric problem were referred to psychiatric clinic for further management. Results: The mean age of the patients was 40 (±13.27) years and the males ( n = 254, 66.1%) predominated than the females ( n = 130, 33.9%). Psychiatric illness was identified in many patients ( n = 91, 24%) including major depressive disorder ( n = 64, 16.7%), suicidal ideas ( n = 31, 8%), panic disorder ( n = 26, 6.8%), and substance abuse ( n = 15, 3.9%). Conclusion: The findings imply the need to integrate screening and referral services for the people undergoing HIV testing. Early screening of psychiatric morbidity among individuals utilizing the ICTC facility may help identify and treat the illness at an early stage.

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Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

Cited by 3 publications

References 40 publications

Depression in HIV Infected Patients: a Review

Depression in HIV Infected Patients: a Review

Prevalence, impact, and management of depression and anxiety in patients with HIV: a review

Psychiatric morbidity among human immunodeficiency virus test seekers attending the integrated counseling and testing center facility of a tertiary care hospital in South India

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