Depression is the most common psychiatric disorder in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (Rabkin et al., 2008). Depression rates are 5 to 10 times higher in HIV/AIDS than in the general population. Depression is associated with several negative outcomes including lower compliance to anti-retroviral therapy (ART), higher viral load, and more suicidal behavior (Nanni et al., 2015). Managing depression in HIV/AIDS according to evidence-based principles is crucial to reduce the burden associated with in HIV/AIDS, and to improve the quality of life of seropositive individuals.
Methods:
This review summarized manuscripts obtained in searches in five electronic databases. Articles with higher level of evidence (particularly systematic reviews and meta-analyses) were prioritized.
Results:
Treatment of depression in HIV/AIDS relies in three different groups on interventions: 1) the use of medications, particularly, antidepressants (Eshun‐Wilson et al., 2018), 2) individuals and group psychotherapeutic interventions (Spies et al., 2013), and 3) management of other elements that contribute to depression in HIV/AIDS such as infectious-immunological, exogenous and psychosocial factors.
Discussion:
In the pharmacological management of depression in HIV/AIDS, it is important to pay attention to several different factors including drug-drug interactions, impact of medications of immune function, and higher incidence of some side effects in seropositive individual (Watkins et al., 2011). Psychotherapy is less available than medications but also tends to be beneficial and cost-effective. Finally, ensuring that the patient is compliant to ART, appropriately treating co-occurring substance use disorders, and other exogenous factors are crucial in the management of depression in HIV/AIDS.
Conclusion/Implications:
To appropriate manage depression in HIV/AIDS, it is important to have a comprehensive and evidence-based approach that includes different treatment modalities.
References
Eshun‐Wilson I, Siegfried N, Akena DH, Stein DJ, Obuku EA, Joska JA. Antidepressants for depression in adults with HIV infection. Cochrane Database of Systematic Reviews. 2018(1).
Nanni MG, Caruso R, Mitchell AJ, Meggiolaro E, Grassi L. Depression in HIV infected patients: a review. Current psychiatry reports. 2015 Jan;17(1):1-1.
Rabkin JG. HIV and depression: 2008 review and update. Current Hiv/aids Reports. 2008 Nov 1;5(4):163-71.
Spies G, Asmal L, Seedat S. Cognitive-behavioural interventions for mood and anxiety disorders in HIV: a systematic review. Journal of affective disorders. 2013 Sep 5;150(2):171-80.
Watkins CC, Pieper AA, Treisman GJ. Safety considerations in drug treatment of depression in HIV-positive patients. Drug safety. 2011 Aug;34(8):623-39.
Learning Objectives:
To appropriate manage depression in HIV/AIDS, it is important to have a comprehensive and evidence-based approach that includes different treatment modalities
