Depression

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

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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.
  • First-degree relatives of pts with MDD at greater risk than general population.
  • Active alcohol or drug use 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.
  • Untreated MDD associated with nonadherence to medications and medical appointments, increased high risk sexual behavior, alcohol and substance use, poorer quality of life, and increased morbidity and mortality in HIV pts.
  • Suicide rate in AIDS pts 7x higher than in general population. Risk for suicide greatest in first few mos. following initial Dx of HIV and with onset of medical complications of AIDS.

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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.
  • First-degree relatives of pts with MDD at greater risk than general population.
  • Active alcohol or drug use 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.
  • Untreated MDD associated with nonadherence to medications and medical appointments, increased high risk sexual behavior, alcohol and substance use, poorer quality of life, and increased morbidity and mortality in HIV pts.
  • Suicide rate in AIDS pts 7x higher than in general population. Risk for suicide greatest in first few mos. following initial Dx of HIV and with onset of medical complications of AIDS.

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Last updated: January 10, 2018