Depression

CLINICAL

• Prevalence of major depressive disorder (MDD) in HIV pts 2-3x higher than general population; most common psychiatric condition in HIV+ pts. Prevalence of depression 57% in HIV+ pts. and 70% in HIV/HCV coinfected pts.
• Lifetime risk of developing MDD 2x greater in women vs. men. Prevalence of MDD in HIV+ women up to 4x higher than HIV-negative women and 3x higher than HIV+ men.
• 1st degree relatives of pts with MDD at greater risk than general population.
• Alcohol, cocaine or amphetamine dependence may contribute to onset or exacerbation of MDD.
• MDD in HIV pts. often under-Dx’d as many Sx similar to Sx of HIV infection or AIDS-related medical complications: e.g., decreased energy, weight loss, insomnia, neurocognitive disturbance.
• Pts with untreated MDD less likely to adhere to medications and keep medical appointments; more likely to engage in high risk sexual behavior and substance abuse. Untreated depression associated with increased morbidity and mortality in HIV pts.
• Suicide rate in AIDS pts 7x higher than in general population. Risk for suicide greatest in 1st few mos. following initial Dx of HIV and with onset of medical complications of AIDS.