Current Psychiatry Reports

, 17:530 | Cite as

Depression in HIV Infected Patients: a Review

  • Maria Giulia NanniEmail author
  • Rosangela Caruso
  • Alex J. Mitchell
  • Elena Meggiolaro
  • Luigi Grassi
Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Complex Medical-Psychiatric Issues


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.


HIV infection Depression Psychosomatic medicine Consultation-liaison psychiatry Psychopharmacology Psychosocial intervention 


Compliance with Ethics Guidelines

Conflict of Interest

Maria Giulia Nanni, Rosangela Caruso, Alex J Mitchell, Elena Meggiolaro, and Luigi Grassi declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Report of the global AIDS Epidemic 2013, Joint United Nations Program on HIV/AIDS, 2013,
  2. 2.
    Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. Plos Med. 2006;3(11):e442.2006.Google Scholar
  3. 3.
    Dubè B, Benton T, Cruess DG, Evans DL. Neuropsychiatric manifestations of HIV infection and AIDS. J Psychiatry Neurosci. 2005;30(4):237–46.PubMedCentralPubMedGoogle Scholar
  4. 4.•
    Owe-Larsson B, Säll L, Salamon E, Allgulander C. HIV infection and psychiatric illness. Afr J Psychiatry (Johannesbg). 2009;12(2):115–28. The review examines in a comprehensive way the prevalence and clinical features of the most common HIV-related neuropsychiatric disorders.Google Scholar
  5. 5.
    Watkins CC, Pieper AA, Treisman GJ. Safety considerations in drug treatment of depression in HIV-positive patients: an updated review. Drug Saf. 2011;34(8):623–39.PubMedGoogle Scholar
  6. 6.•
    Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001;158:725–30. This study used meta-analytic techniques to examine the relationship between depressive disorders and HIV infection and the risk that HIV-positive individuals have to develop depression compared with seronegative controls.PubMedGoogle Scholar
  7. 7.
    Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.PubMedGoogle Scholar
  8. 8.
    Nacher M, Adriouch L, Godard Sebillotte C, Hanf M, Vantilcke V, El Guedj M, et al. Predictive factors and incidence of anxiety and depression in a cohort of HIV-positive patients in French Guiana. AIDS Care. 2010;22(9):1086–92.PubMedGoogle Scholar
  9. 9.
    Meade CS, Sikkema KJ. HIV risk behavior among adults with severe mental illness: a systematic review. Clin Psychol Rev. 2005;25(4):433–57. Epub 2005 Apr 12.PubMedGoogle Scholar
  10. 10.
    Simoni JM, Safren SA, Manhart LE, Lyda K, Grossman CI, Rao D, et al. Challenges in addressing depression in HIV research: assessment, cultural context, and methods. AIDS Behav. 2011;15(2):376–88.PubMedCentralPubMedGoogle Scholar
  11. 11.
    Phillips KD, Sowell RL, Rojas M, Tavakoli A, Fulk LJ, Hand GA. Physiological and psychological correlates of fatigue in HIV disease. Biol Res Nurs. 2004;6(1):59–74.PubMedGoogle Scholar
  12. 12.••
    Schuster R, Bornovalova M, Hunt E. The influence of depression on the progression of HIV: direct and indirect effects. Behav Modif. 2012;36(2):123–45. This recent review describes a comprehensive multipath model, that explains the direct and indirect pathways leading from depression to HIV progression.PubMedGoogle Scholar
  13. 13.
    Alciati A, Starace F, Scaramelli B, Campaniello M, Adriani B, Mellado C, et al. Has there been a decrease in the prevalence of mood disorders in HIV-seropositive individuals since the introduction of combination therapy? Eur Psychiatry. 2001;16(8):491–6.PubMedGoogle Scholar
  14. 14.•
    Watkins CC, Treisman GJ. Neuropsychiatric complications of aging with HIV. J Neurovirol. 2012;18(4):277–90. This recent review well summarizes the current theories and research that link aging and HIV with psychiatric illnesses.PubMedGoogle Scholar
  15. 15.
    Battegay M, Haerry DH, Fehr J, Staehelin C, Wandeler G, Elzi L. Psychosoziale aspekte bei der behandlung der hiv-infektion [in process citation]. Ther Umsch. 2014;71(8):509–13.PubMedGoogle Scholar
  16. 16.
    Asch SM, Kilbourne AM, Gifford AL, Burnam MA, Turner B, Shapiro MF, et al. HCSUS consortium. Underdiagnosis of depression in HIV: who are we missing? J Gen Intern Med. 2003;18(6):450–60.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Pence BW, O’Donnell JK, Gaynes N. Falling through the cracks: the gaps between depression prevalence, diagnosis, treatment, and response in HIV care. AIDS. 2012;26(5):656–8.PubMedCentralPubMedGoogle Scholar
  18. 18.
    Mayston R, Kinyanda E, Chishinga N, Prince M, Patel V. Mental disorder and the outcome of HIV/AIDS in low-income and middle-income countries: a systematic review. AIDS. 2012;26 Suppl 2:S117–35.PubMedGoogle Scholar
  19. 19.
    Carrico AW, Bangsberg DR, Weiser SD, Chartier M, Dilworth SE, Riley ED. Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons. AIDS. 2011;25(8):1113–8.PubMedCentralPubMedGoogle Scholar
  20. 20.
    Sumari-de Boer IM, Sprangers MA, Prins JM, Nieuwkerk PT. HIV stigma and depressive symptoms are related to adherence and virological response to ART among immigrant and indigenous HIV infected patients. AIDS Behav. 2012;16:1681–9.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237–47.PubMedGoogle Scholar
  22. 22.
    Sabin CA, Ryom L, De Wit S, Mocrof A, Phillips AN, Worm SW, et al. Association between immune depression and cardiovascular events in HIV infection. AIDS. 2013;27(17):2735–48.PubMedGoogle Scholar
  23. 23.
    Mitchell AJ, Lord O, Malone D. Differences in the prescribing of medication for physical disorders in individuals with v. without mental illness: a meta-analysis. Br J Psychiatry. 2012;201(6):435–43.PubMedGoogle Scholar
  24. 24.
    Bouhnik AD, Préau M, Vincent E, Carrieri MP, Gallais H, Lepeu G, et al. Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antivir Ther. 2005;10(1):53–61.PubMedGoogle Scholar
  25. 25.
    Ammassari A, Antinori A, Aloisi MS, Trotta MP, Murri R, Bartoli L, et al. Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics. 2004;45(5):394–402.PubMedGoogle Scholar
  26. 26.
    Kleeberger CA, Buechner J, Patella F, Detels R, Riddler S, Godfrey R, et al. Changes in adherence to highly active antiretroviral medications in the multicenter AIDS cohort study. AIDS. 2004;18(4):683–8.PubMedGoogle Scholar
  27. 27.
    Alciati A, Gallo L, Monforte AD, Brambilla F, Mellado C. Major depression-related immunological changes and combination antiretroviral therapy in HIV-seropositive patients. Hum Psychopharmacol. 2007;22(1):33–40.PubMedGoogle Scholar
  28. 28.
    Leserman J. HIV disease progression: depression, stress and possible mechanisms. Biol Psychiatry. 2003;54(3):295–306.PubMedGoogle Scholar
  29. 29.
    Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008;70(5):539–45.PubMedGoogle Scholar
  30. 30.
    Coleman SM, Blashill AJ, Gandhi RT, Safren SA, Freudenreich O. Impact of integrated and measurement-based depression care: clinical experience in an HIV clinic. Psychosomatics. 2012;53(1):51–7.PubMedGoogle Scholar
  31. 31.
    Tsai AC, Weiser SD, Peterson ML, Ragland K, Kushel MB, Bangsberg DR. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV. Arch Gen Psychiatry. 2010;67(12):1282–90.PubMedCentralPubMedGoogle Scholar
  32. 32.
    Chen WT, Shiu CS, Yang JP, Simoni JM, Fredriksen-Goldsen KI, Lee TS, et al. Antiretroviral therapy (ART) side effect impacted on quality of life, and depressive symptomatology: a mixed-method study. J AIDS Clin Res. 2013;4:218.PubMedCentralPubMedGoogle Scholar
  33. 33.
    Chauhan VS, Chaudury S, Sudarsanan S, Srivastava K. Psychiatric morbidity in asymptomatic human immunodeficiency virus patients. Ind Psychiatry J. 2013;22(2):125–30.PubMedCentralPubMedGoogle Scholar
  34. 34.
    Elenga N et al. Incidence and predictive factors of depression among patients with HIV infection in Guadeluope: 1988–2009. Int J of STD & AIDS. 2014;25(8):559–63.Google Scholar
  35. 35.••
    Sherr L, Clucas C, Harding R, Sibley E, Catalan J. HIV and depression—a systematic review of interventions. Psychol Health Med. 2011;16(5):493–527. This review provides a comprehensive understanding of the most important treatment interventions (psychological, psychotropic, psychosocial, physical, HIV-specific health psychology interventions) proposed for depression in HIV infected patients.PubMedGoogle Scholar
  36. 36.
    Gaynes BN, Pence BW, Eron Jr JJ, Miller WC. Prevalence and comorbidity of psychiatric diagnoses based on reference standard in an HIV+ patient population. Psychosom Med. 2008;70(4):505–11.PubMedCentralPubMedGoogle Scholar
  37. 37.
    Eller LS, Rivero-Mendez M, Voss J, Chen WT, Chaiphibalsarisdi P, Iipinge S, et al. Depressive symptoms, self esteem, HIV symptom management self-efficacy and self-compassion in people living with HIV. AIDS Care. 2014;26(7):795–803.PubMedGoogle Scholar
  38. 38.
    Kagee A, Martin L. Symptoms of depression and anxiety among a sample of South African patients living with HIV. AIDS Care. 2010;22(2):159–65.PubMedGoogle Scholar
  39. 39.
    L’Akoa RM, Noubiap JJ, Fang Y, Ntone FE, Kuaban C. Prevalence and correlates of depressive symptoms in HIV-positive patients: a cross-sectional study among newly diagnosed patients in Yaoundé, Cameroon. BMC Psychiatry. 2013;13:228.PubMedCentralPubMedGoogle Scholar
  40. 40.
    Ramirez-Avila L, Regan S, Giddy J, Chetty S, Ross D, Katz JN, et al. Depressive symptoms and their impact on health-seeking behaviors in newly-diagnosed HIV-infected patients in Durban, South Africa. AIDS Behav. 2012;16(8):2226–35.PubMedCentralPubMedGoogle Scholar
  41. 41.
    Williams AB, Wang H, Li X, Chen J, Li L, Fennie K. Efficacy of an evidence-based ARV adherence intervention in China. AIDS Patient Care STDS. 2014;28(8):411–7. Epub 2014 Jul 21.PubMedGoogle Scholar
  42. 42.
    Braganca M, Palha A. Depression and neurocognitive performance in Portuguese patients infected with HIV. AIDS Behav. 2011;15(8):1879–87.PubMedGoogle Scholar
  43. 43.
    Talukdar A, Talukdar PS, Ghosal MK, Bal R, Ghosh P, Goswami DN. Evaluation of depression and coping skill among HIV-positive people in Kolkata, India. J Int Assoc Physicians AIDS Care (Chic). 2012;11(2):115–20.Google Scholar
  44. 44.
    Dal-Bò MJ, Manoel AL, Filho AO, Silva BQ, Cardoso YS, Cortez J, Tramujas L, Silva RM. Depressive symptoms and associated factors among people with HIV/AIDS. J Int Assoc Provid AIDS Care, 2013.Google Scholar
  45. 45.
    Grassi L. Risk of HIV infection in psychiatrically ill patients. AIDS Care. 1996;8(1):103–16.PubMedGoogle Scholar
  46. 46.
    Carey MP, Carey KB, Maisto SA, Schroder KE, Vanable PA, Gordon CM. HIV risk behavior among psychiatric outpatients: association with psychiatric disorder, substance use disorder, and gender. J Nerv Ment Dis. 2004;192(4):289–96.PubMedCentralPubMedGoogle Scholar
  47. 47.
    Rosenberg SD, Trumbetta SL, Mueser KT, Goodman LA, Osher FC, Vidaver RM, et al. Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness. Am J Public Health. 2001;91(1):31–7.PubMedCentralPubMedGoogle Scholar
  48. 48.
    Wu ES, Rothbard A, Blank MB. Using psychiatric symptomatology to assess risk for HIV infection in individuals with severe mental illness. Community Ment Health J. 2011;47(6):672–8.PubMedGoogle Scholar
  49. 49.
    Armstrong G, Jorm AF, Samson L, Joubert L, Nuken A, Singh S, et al. Association of depression, anxiety, and suicidal ideation with high-risk behaviors among men who inject drugs in Delhi, India. J Acquir Immune Defic Syndr. 2013;64(5):502–10.PubMedGoogle Scholar
  50. 50.
    Richards D. Prevalence and clinical course of depression: a review. Clin Psychol Rev. 2011;31(7):117–25.Google Scholar
  51. 51.
    Ickovics JR, Hamburger ME, Vlahov D, Shoenbaum EE, Schuman P, Boland RJ, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: longitudinal analysis from the HIV epidemiology research study. JAMA. 2001;285(11):1466–74.PubMedGoogle Scholar
  52. 52.
    Robertson K, Bayon C, Molina JM, McNamara P, Resch C, Muñoz-Moreno JA, et al. Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada. AIDS Care. 2014;16:1–7.Google Scholar
  53. 53.
    Morrison MF, Petitto JM, Ten Have T, Gettes DR, Chiappini MS, Weber AL, et al. Depressive and anxiety disorders in women with HIV infection. Am J Psychiatry. 2002;159:789–96.PubMedGoogle Scholar
  54. 54.
    McArthur JC, Steiner J, Sacktor N, Nath A. Human immunodeficiency virus-associated neurocognitive disorders: mind the gap. Ann Neurol. 2010;67(6):699–714.PubMedGoogle Scholar
  55. 55.
    Springer SA, Chen S, Altice F. Depression and symptomatic response among HIV-infected drug users enrolled in a randomized controlled trial of directly administered antiretroviral therapy. AIDS Care. 2009;21(8):976–83.PubMedCentralPubMedGoogle Scholar
  56. 56.
    Omiya T, Yamazaki Y, Shimada M, Ikeda K, Ishiuchi-Ishitani S, Tsuno YS, et al. Mental health of patients with human immunodeficiency virus in Japan: a comparative analysis of employed and unemployed patients. AIDS Care. 2014;26(11):1370–8. Epub 2014 May 20.PubMedGoogle Scholar
  57. 57.
    Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban–rural differences in psychiatric disorders. Acta Psychiatr Scand. 2010;121:84–93.PubMedGoogle Scholar
  58. 58.
    Hinnen C, Schreuder I, Jong E, van Duijn M, Dahmen R, van Gorp EC. The contribution of adult attachment and perceived social support to depressive symptoms in patients with HIV. AIDS Care. 2012;24(12):1535–42. Epub 2012 Apr 24.PubMedGoogle Scholar
  59. 59.
    Talukdar A, Ghosal MK, Sanyal D, Talukdar PS, Guha P, Guha SK, et al. Determinants of quality of life in HIV-infected patients receiving highly active antiretroviral treatment at a medical college ART center in Kolkata, India. J Int Assoc Provid AIDS Care. 2013;12(4):284–90.PubMedGoogle Scholar
  60. 60.••
    Del Guerra FB, Fonseca JLI, Figueiredo VM, Ziff EB, Konkiewitz EC. Human immunodeficiency virus-associated depression: contributions of immuno-inflammatory, monoaminergic, neurodegenerative, and neurotropic pathways. J Neurovirol. 2013;19:314–27. This is a very recent review that gives a comprehensive understanding regarding the role of neuroendocrine, immunoinflammatory and monoaminergic mechanisms in predisposing HIV-positive patients to develop depression.PubMedGoogle Scholar
  61. 61.
    Kaul M, Lipton SA. Mechanisms of neuroimmunity and neurodegeneration associated with HIV-1 infection and AIDS. J Neuroimmune Pharmacol. 2006;1(2):138–51.PubMedGoogle Scholar
  62. 62.
    Gendelman HE, Lipton SA, Tardieu M, Bukrinsky MI, Nottet HS. The neuropathogenesis of HIV-1 infection. J Leukoc Biol. 1994;56(3):389–98.PubMedGoogle Scholar
  63. 63.
    Lawrence DM, Durham LC, Scwartz L, Seth P, Maric D, Major EO. Human immunodeficiency virus type 1 infection of human brain-derived progenitor cells. J Virol. 2004;78(14):7319–28.PubMedCentralPubMedGoogle Scholar
  64. 64.
    Leonard BE. The concept of depression as a dysfunction of the immune system. Curr Immunol Rev. 2010;6(3):205–12.PubMedCentralPubMedGoogle Scholar
  65. 65.
    Krishnadas R, Cavanagh J. Depression: an inflammatory illness? J Neurosurg Psychiatry. 2012;83(5):495–502.Google Scholar
  66. 66.
    Poudel-Tandukar K, Bertone-Johnson ER, Palmer PH, Poudel KC. C-reactive protein and depression in persons with human immunodeficiency virus infection: the positive living with HIV (POLSH) study. Brain Behav Immun. 2014.Google Scholar
  67. 67.
    Danzter R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9(1):46–56.Google Scholar
  68. 68.
    Appay V, Sauce D. Immune activation and inflammation in HIV-1 infection: causes and consequences. J Pathol. 2008;214(2):231–41.PubMedGoogle Scholar
  69. 69.
    Hasler G. Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry. 2010;9(3):155–61.PubMedCentralPubMedGoogle Scholar
  70. 70.
    Readler TJ. Inflammatory mechanisms in major depressive disorder. Curr Opin Psychiatry. 2011;24(6):519–25.Google Scholar
  71. 71.
    Capuron L, Pagnosi G, Demetrashvili MF, Lawson DH, Fornwalt FB, Woolwine B, et al. Basal ganglia hypermetabolism and symptoms of fatigue during interferon-alpha therapy. Neuropsychopharmacology. 2007;32(11):2384–92.PubMedGoogle Scholar
  72. 72.
    Brydon L, Harrison NA, Walker C, Steptoe A, Critchley HD. Peripheral inflammation is associated with substantia nigra activity and psychomotor slowing in humans. Biol Psychiatry. 2008;63(11):1022–9. Epub 2008 Feb 1.PubMedCentralPubMedGoogle Scholar
  73. 73.
    Barack O, Goshen I, Ben-Hur T, Weidenfelt J, Taylor AN, Yirmiya R. Involvement of brain cytokines in the neurobehavioral disturbances induced by HIV-1 glycoprotein 120. Brain Res. 2002;933(2):98–108.Google Scholar
  74. 74.
    Lawson MA, Kelley KW, Dantzer R. Intracerebroventricular administration of HIV-1 Tat induces brain cytokine and indoleamine 2,3-dioxygenase expression: a possible mechanism for AIDS comorbid depression. Brain Behav Immun. 2011;25(8):1569–75. Epub 2011 May 17.PubMedCentralPubMedGoogle Scholar
  75. 75.
    Danzter R, O’Connor JC, Lawson MA, Kelley KW. Inflammation-associated depression: from serotonin to kynurenine. Psychoneuroendocrinology. 2011;36(3):426–36. Epub 2010 Oct 30.Google Scholar
  76. 76.•
    Gutiérrez F, García L, Padilla S, Alvarez D, Moreno S, Navarro G, et al. Risk of clinically significant depression in HIV-infected patients: effect of antiretroviral drugs. HIV Med. 2014;15(4):213–23. This very recent study characterizes depression in a large sample of newly diagnosed HIV-infected patients and determines the effect of antiretroviral therapy (ART), on its incidence, investigate whether efavirenz use was associated with a higher risk, compared with non-efavirenz-containing regimens.PubMedGoogle Scholar
  77. 77.
    Zhang L, Yang D, Zhao HX, Han N, Xiao J, Chen YF, et al. Assessment on depressive status and the therapeutic effects of highly active antiretroviral therapy among anti-HIV-1(+) population. Zhonghua Liu Xing Bing Xue Za Zhi. 2013;34(5):461–3.PubMedGoogle Scholar
  78. 78.
    Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust. 2009;190:S54–60.PubMedGoogle Scholar
  79. 79.
    Golub SA, Gamarel KE, Rendina HJ. Loss and growth: identity processes with distinct and complementary impacts on well-being among those living with chronic illness. Psychol Health Med. 2013;19(5):572–9. Epub 2013 Nov 15.PubMedGoogle Scholar
  80. 80.
    Schuster RM, Gonzalez R. Substance abuse, hepatitis C, and aging in HIV: common cofactors that contribute to neurobehavioral disturbances. Neurobehav HIV Med. 2012;2012(4):15–34.PubMedCentralPubMedGoogle Scholar
  81. 81.
    Grassi L, Righi R, Makoui S, Sighinolfi L, Ferri S, Ghinelli F. Illness behaviour, emotional stress and psychosocial factors among asymptomatic HIV-infected patients. Psychother Psychosom. 1999;68(1):31–8.PubMedGoogle Scholar
  82. 82.•
    Logie C, Gadalla TM. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21(6):742–53. This study analyzes with meta-analytic techniques the relationship between HIV-related stigma, the main psychosocial variable stressed by the literature, and demographical, social, physical and health characteristics of the patients.PubMedGoogle Scholar
  83. 83.
    Lowther K, Selman L, Harding R, Higginson IJ. Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): a systematic review. Intern J Nurs Stud. 2014;51(8):1171–89.Google Scholar
  84. 84.
    Nachega JB, Morroni C, Zuniga JM, Sherer R, Beyrer C, Solomon S, et al. HIV-related stigma, isolation, discrimination, and serostatus disclosure: a global survey of 2035 HIV-infected adults. J Int Assoc Physicians AIDS Care (Chic). 2012;11(3):172–8.Google Scholar
  85. 85.
    Agrawal M, Srivastava K, Goyal S, Chaudhury S. Psychosocial correlates of human immunodeficiency virus infected patients. Ind Psychiatry J. 2012;21(1):55–60.PubMedCentralPubMedGoogle Scholar
  86. 86.
    Stutterheim SE, Pryor JB, Bos AE, Hoogendijk R, Muris P, Schaalma HP. HIV-related stigma and psychological distress: the harmful effects of specific stigma manifestations in various social settings. AIDS. 2009;23(17):2353–7.PubMedGoogle Scholar
  87. 87.
    Breet E, Kagee A, Seedat S. HIV-related stigma and symptoms of post-traumatic stress disorder and depression in HIV-infected individuals: does social support play a mediating or moderating role? AIDS Care. 2014;26(8):947–51.PubMedGoogle Scholar
  88. 88.
    Benton TD. Depression and HIV/AIDS. Curr Psychiatry Rep. 2008;10(3):280–5.PubMedGoogle Scholar
  89. 89.
    Kalichman SC, Rompa D, Cage M. Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV/AIDS. J Nerv Ment Dis. 2000;188:662–70.PubMedGoogle Scholar
  90. 90.
    Gibbie T, Mijch A, Ellen S, et al. Depression and neurocognitive performance in individuals with HIV/AIDS: 2-year follow-up. HIV Med. 2006;7:112–21.PubMedGoogle Scholar
  91. 91.
    Castellon SA, Hardy DJ, Hinkin CH, Satz P, Stenquist PK, van Gorp WG, et al. Components of depression in HIV-1 infection: their differential relationship to neurocognitive performance. J Clin Exp Neuropsychol. 2006;28(3):420–37.PubMedCentralPubMedGoogle Scholar
  92. 92.
    Grant I. Neurocognitive disturbances in HIV. Int Rev Psychiatry. 2008;20:33–47.PubMedGoogle Scholar
  93. 93.
    Wolff LC, Alvarado MR, Wolff RM. Depression in HIV infection: prevalence, risk factors and management. Rev Chil Infectol. 2010;27(1):65–74.Google Scholar
  94. 94.
    Gazzard B, Balkin A, Hill A. Analysis of neuropsychiatric adverse events during clinical trials of efavirenz in antiretroviral-naive patients: a systematic review. AIDS Rev. 2010;12:67–75.PubMedGoogle Scholar
  95. 95.
    Clifford DB, Evans S, Yang Y, Acosta EP, Ribaudo H, Gulick R. Long-term impact of efavirenz on neuropsychological performance and symptoms in HIV-infected individuals (ACTG 5097s). HIV Clin Trials. 2009;10:343–55.PubMedCentralPubMedGoogle Scholar
  96. 96.
    American Psychiatric Association (APA). Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. Arlington (VA): American Psychiatric Association (APA); 2010 Oct. p152,
  97. 97.
    European AIDS Clinica Society. Guidelines version 7.2, Jun 2014,
  98. 98.
    Harrison DL, Miller MJ, Schmitt MR, Touchet BK. Variation in the probability of depression screening at community-based physician practice visit. Prim Care Companion J Clin Psychiatry. 2010;12(5):e1–8.Google Scholar
  99. 99.
    Shacham E, Nurutdinova D, Satinarajana V, Stamm K, Overtone ET. Routine screening for depression: identifying a challenge for successful HIV care. AIDS Patients Care STDs. 2009;23(11):949–55.Google Scholar
  100. 100.•
    Akena D, Joska J, Obuku EA, Amos T, Musisi S, Stein DJ. Comparison the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review. BMC Psychiatry. 2012;12:187. This recent review provides a comprehensive description of the available validated tools used to assess depression in HIV context, making a comparison between short and long instruments.PubMedCentralPubMedGoogle Scholar
  101. 101.
    Mitchell AJ, Coyne JC. Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. Br J Gen Pract. 2007;57(535):144–51.PubMedCentralPubMedGoogle Scholar
  102. 102.
    Cholera R, Gaynes BN, Pence BW, Bassett J, Qangule N, Macphail C, et al. Validity of the patient health questionnaire-9 to screen for depression in a high HIV burden primary healthcare clinic in Johannesburg, South Africa. J Affect Disord. 2014;167:160–6.PubMedGoogle Scholar
  103. 103.
    Gordon S, Adul K, Kidd M, Smit J, Landon M, Dan S, et al. Validity of the K-10 in detecting DSM-IV-defined depression and anxiety disorders among HIV-infected individuals. AIDS Care. 2009;21:1163–8.Google Scholar
  104. 104.
    Chishinga N, Kinyanda E, Weiss HA, Patel V, Ayles H, Seedat S. Validation of brief screening tools for depression and alcohol use disorders among TB and HIV patients in primary care in Zambia. BMC Pschiatra. 2011;11:75.Google Scholar
  105. 105.
    Primeau MM, Avellaneda V, Musselman D, St Jean G, Illa L. Treatment of depression in individuals living with HIV/AIDS. Psychosomatics. 2013;54(4):336–44.PubMedGoogle Scholar
  106. 106.••
    Spies G, Asmal L, Seedat S. Cognitive-behavioral interventions for mood and anxiety disorders in HIV: a systematic review. J Affect Disord. 2013;150:171–80. The present recent study reviews the existing literature on the use of CBI for depression in HIV-positive adults and to assess the effect size of these interventions.PubMedGoogle Scholar
  107. 107.•
    Himelhoch S, Medoff DR, Oyeniyi G. Efficacy of group psychotherapy to reduce depressive symptoms among HIV-infected individuals: a systematic review and meta-analysis. AIDS Patient Care STDS. 2007;21(10):732–9. This is a systematic review and meta-analysis of double-blinded, randomized controlled trials to examine efficacy of group psychotherapy treatment among HIV infected with depressive symptoms.PubMedGoogle Scholar
  108. 108.
    Hogagodu AR, Krishna M, Sundarachar R, Lepping P. Group psychotherapies for depression in persons with HIV: a systematic review. Indian J Psychiatry. 2013;55(4):323–30.Google Scholar
  109. 109.
    Repetto MJ, Petitto JM. Psychopharmacology in HIV-infected patients. Psychosom Med. 2008;70(5):585–92.PubMedGoogle Scholar
  110. 110.
    Blank MB, Himelhoch S, Walkup J, Eisenberg MM. Treatment considerations for HIV-infected individuals with severe mental illness. Curr HIV/AIDS Rep. 2013;10(4):371–9.PubMedGoogle Scholar
  111. 111.
    Pence BW, Gaynes BN, Atashili J, O’Donnell JK, Kats D, Whetten K, et al. Feasibility, safety, acceptability, and preliminary efficacy of measurement-based care depression treatment for HIV patients in Bamenda, Cameroon. Ndumbe PAIDS Behav. 2014;18(6):1142–51.Google Scholar
  112. 112.
    Pieper AA, Treisman GJ. Drug treatment of depression in HIV-positive patients: safety considerations. Drug Saf. 2005;28(9):753–62.PubMedGoogle Scholar
  113. 113.
    Sin NL, DiMatteo MR. Depression treatment enhances adherence to antiretroviral therapy: a meta-analysis. Ann Behav Med. 2014;47(3):259–69.PubMedGoogle Scholar
  114. 114.••
    Hill L, Lee KC. Pharmacotherapy considerations in patients with HIV and psychiatric disorders: focus on antidepressants and antipsychotics. Ann Pharmacother. 2013;47(1):75–89. Reviewed the evidence for pharmacological treatment in the HIV context. In this recent review the authors analyze the evidence for pharmacological treatment in the HIV context, reporting also the data, very limited in current literature, regarding the use of antipsychotics.PubMedGoogle Scholar
  115. 115.•
    Watson LC, Amick HR, Gaynes BN, Brownley KA, Thaker S, Viswanathan M, et al. Practice-based intervention concomitant depression and chronic medical conditions in the primary care setting: a systematic review and meta-analysis. J Prim Care Community Health. 2013;4(4):294–306. This recent study reviews in a systematic way and with meta-analytic techniques the effectiveness of practice-based interventions for improving depression and chronic medical outcomes in a medical setting.PubMedGoogle Scholar
  116. 116.
    Power R, Gore-Felton C, Vorvick M, Israelski DM, Spiegel D. HIV: effectiveness of complementary and alternative medicine. Prim Care. 2002;29(2):361–78.PubMedGoogle Scholar
  117. 117.
    Fulk LJ, Kane BE, Phillips KD, Bopp CM, Hand GA. Depression in HIV-infected patients: allopathic, complementary, and alternative treatments. J Psychosom Res. 2004;57(4):339–51.PubMedGoogle Scholar
  118. 118.
    Ngô TL. Review of the effects of mindfulness meditation on mental and physical health and its mechanisms of action. Sante Ment Que. 2013;38(2):19–34.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maria Giulia Nanni
    • 1
    • 2
    Email author
  • Rosangela Caruso
    • 1
    • 2
  • Alex J. Mitchell
    • 3
  • Elena Meggiolaro
    • 4
  • Luigi Grassi
    • 1
    • 2
  1. 1.Institute of Psychiatry, Department of Biomedical and Specialty Surgical SciencesUniversity of FerraraFerraraItaly
  2. 2.University Hospital Psychiatry Unit, Program in Psycho-Oncology and Psychiatry in Palliative CareS. Anna University Hospital and Local Health AgenciesFerraraItaly
  3. 3.Department of Psycho-Oncology, Cancer Studies and Molecular MedicineUniversity of LeicesterLeicesterUK
  4. 4.Psycho-Oncology UnitIstituto Scientifico per lo Studio e la Cura dei Tumori (IRST) S.r.l., IRCCSMeldolaItaly

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