Causes

Chemical, biological, and experiential factors (health or social issues), alone or in combination, can result in clinical depression. A family history of mental illness, panic disorder, and alcoholism can increase susceptibility as can some illnesses (multiple sclerosis, stroke, Parkinson's disease), and chronic pain. Sometimes, it may be difficult to identify an apparent reason or precipitating event leading to clinical depression. In a medical setting, roughly 10% of people have clinical depression.

Some symptoms of clinical depression may be induced by HIV disease itself or by HIV medications. These causes should be eliminated before a psychiatric diagnosis is made.

In women with HIV, depression has been associated with accelerated disease progression and death.1 Studies have found that men with HIV or AIDS are more likely to develop depression than the general population, particularly in those aged over 50.2 Co-infection with hepatitis C virus increases the risk of the development of depression.3 One study showed that men with AIDS who have a pet are less likely to experience depression than do men without one.4

Poor nutrition, lack of sunlight, and lack of exercise may all contribute to depression. Conversely, depression has been associated with an increased incidence of unsafe sex and poor adherence to antiretroviral drug regimens.5 6 7 8

References

  1. Antelman G et al. Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. J Acquir Immune Defic Syndr 44: 470-477, 2007
  2. Justice AC et al. Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: Veterans Aging Cohort Five-Site Study. AIDS 18: S49-S59, 2004
  3. Yang Y et al. Hepatitis C and neuropsychological function in treatment naive HIV-1-infected subjects - A5097s baseline analysis. Eleventh Conference on Retroviruses and Opportunistic Infections, San Francisco, abstract 26, 2004
  4. Siegel JM et al. AIDS diagnosis and depression in the Multicenter AIDS Cohort Study: the ameliorating impact of pet ownership. AIDS Care 11(2 ): 157-170, 1999
  5. Desquilbet L et al. Increase in at-risk sexual behaviour among HIV-1-infected patients followed in the French PRIMO cohort. AIDS 16: 2329-2333, 2003
  6. Chin-Hong PV et al. High-risk sexual behavior in HIV-infected adults with genotypically proven antiretroviral resistance. Eleventh Conference on Retroviruses and Opportunistic Infections, San Francisco, abstract 845, 2004
  7. Kleeberger CA et al. Changes in adherence to highly active antiretroviral therapy medications in the Multicenter AIDS Cohort Study. AIDS 18: 683-688, 2004
  8. Vincent E et al. Impact of HAART-related side-effects on unsafe sexual behaviours in HIV-infected injecting drug users: 7-year follow-up. AIDS 18: 1321-1325, 2004
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