Washington D.C. [USA], April 12 : HIV/AIDS diagnosed people are likely to be more prone to the risks of depressive disorders.
However, a literature review from the Harvard Review of Psychiatry, suggests that in many cases, these conditions go "unrecognised or untreated".
As per the reports of Gustavo C. Medeiros, MD, of the University of Texas Southwestern Medical Center, Dallas, and colleagues, proper diagnosis and management are essential to reduce negative health effects of depression in patients with HIV/AIDS.
Based on an analysis of 125 research publications, "We provide evidence-based recommendations to improve the assessment and management of depressive disorders in seropositive persons," the researchers write.
Depressive disorders are linked to negative health outcomes including poorer compliance with antiretroviral therapy, lower immune function (CD4 cell count), and a higher mortality rate.
Dr. Medeiros and colleagues seek to provide an "updated, practical, and global overview" of depression in HIV/AIDS. Depressive disorders are vastly underdiagnosed in HIV/AIDS," according to the authors.
Patient assessment is complex due to the overlap between depression and HIV/AIDS symptoms, including fatigue, insomnia, and reduced appetite. Hence, making the correct diagnosis is essential for providing the appropriate treatment.
Depressive symptoms in patients with HIV/AIDS also may be due to other medical conditions, medications or addictive substances, adjustment disorder or other psychiatric disorders.
Direct brain damage caused by HIV, as well as psychosocial factors such as chronic stress, HIV-related stigma, and social isolation, can also be other contributing factors.
Accessing the treatment part, one study reported that only seven percent of HIV-positive patients with MDD (Major Depressive Disorder) had access to adequate treatment.
Selective serotonin reuptake inhibitors (SSRIs) are the first-choice medications; other antidepressants may be used but require close monitoring for side effects and drug interactions.
Individual or group psychotherapy can also be counted as a helpful treatment method. It's also essential to ensure proper management of HIV/AIDS and related medical conditions.
The combination of depression and HIV/AIDS is strongly linked to suicide, with rates eight to ten times higher than in the general population. Depression also poses special challenges in adolescents and older adults with HIV/AIDS.