Johns Hopkins HIV GuideDiagnosisOrgan SystemPsychiatric

Anxiety

Jeffrey Hsu, M.D., Glenn Treisman, M.D., PH.D., Andrew Angelino, M.D.
Anxiety is a topic covered in the Johns Hopkins HIV Guide.

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CLINICAL

  • Anxiety is a common symptom that occurs in response to stressful life circumstances, but can also be a Sx of an anxiety disorder or another underlying disorder (such as major depression).
  • Diagnosable anxiety disorders may be present in up to 40% of HIV+ pts, but prevalence of anxiety Sxs (without Dx’d disorder) even higher (up to 72%). Sxs are twice as commonly reported in women vs. men.
  • Can be prominent Sx in pts first Dx’d with HIV, and in response to progression, such as declining CD4, OIs.
  • Diagnostic overlap with other conditions. >50% of pts with anxiety disorders have comorbid depression. Alcohol dependence also common (esp. in women).
  • Anxiety can increase likelihood of HIV risk behaviors and ART nonadherence. Also, HIV+ pts. with panic disorder (PD) and post-traumatic stress disorder (PTSD) experience greater pain intensity and related dysfunction.
  • Common medical conditions associated with anxiety Sx include hypoxia, stimulant intoxication, withdrawal from sedative-hypnotics, seizures, hyperthyroidism, pheochromocytoma. Anxiety can also be a side effect of EFV, interferon, or corticosteroid treatment.

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Last updated: November 2, 2011