Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121, Ferrara, Italy,
Curr Psychiatry Rep. 2015 Jan;17(1):530. doi: 10.1007/s11920-014-0530-4.
Depression is the most common neuropsychiatric complication in HIV-infected patients and may occur in all phases of the infection. Accurately, diagnosing major depressive disorder in the context of HIV is an ongoing challenge to clinicians and researchers, being complicated by the complex biological, psychological, and social factors associated with the HIV illness. Evidences exist to support the importance of improving the identification of depressive symptoms and their adequate treatment. Depression has long been recognized as a predictor of negative clinical outcomes in HIV-infected patients, such as reducing medication adherence, quality of life, and treatment outcome, and possibly worsening the progression of the illness and increasing mortality. By analyzing the most relevant studies (MEDLINE, EMBASE, PsycLit, Cochrane Library), the review discusses the epidemiology and the main clinical features of depression in HIV-infected patients, the causal pathways linking depression and HIV infection, the validity of screening tools, and the efficacy of different treatment approaches, including psychosocial interventions, psychopharmacology as well as HIV-specific health psychology health service models.
抑郁症是 HIV 感染患者中最常见的神经精神并发症，可能发生在感染的所有阶段。在 HIV 背景下准确诊断重度抑郁症是临床医生和研究人员面临的持续挑战，这与 HIV 疾病相关的复杂生物、心理和社会因素有关。有证据表明，改善抑郁症状的识别及其充分治疗非常重要。抑郁症长期以来一直被认为是 HIV 感染患者负面临床结局的预测因素，例如降低药物依从性、生活质量和治疗效果，并可能使病情恶化和增加死亡率。通过分析最相关的研究（MEDLINE、EMBASE、PsycLit、Cochrane Library），综述讨论了 HIV 感染患者中抑郁症的流行病学和主要临床特征、将抑郁症与 HIV 感染联系起来的因果途径、筛查工具的有效性以及不同治疗方法的疗效，包括心理社会干预、精神药理学以及 HIV 特定健康心理学卫生服务模式。
