HIV clinical care providers are increasingly confronted by comorbid psychiatric illness among their patients. Prevalence rates of psychiatric disorders among HIV-infected patients approach 50%. These conditions commonly manifest around the time of diagnosis, but many patients develop symptoms later in their course of illness. Axis I disorders, including anxiety and depression, are particularly likely to occur at times of stress-including an illness episode, a psychosocial stressor such as divorce or loss of a loved one, and when facing a new disability. Anxiety and depression are among the most commonly diagnosed psychiatric conditions affecting HIV-infected patients.[3,4] These can complicate the treatment of HIV, presenting numerous diagnostic and interventional challenges for the clinician.
The authors provide information about diagnosing and treating depression and anxiety. If left untreated, these disorders can affect the ability of an HIV patient to adhere to therapy and therefore affect the course of the patient's HIV disease. If there is a history of substance abuse, failure to treat these psychiatric illnesses may lead to a relapse into substance using behaviors. Even for non-HIV patients, they note, diagnosis and treatment of these illnesses is important because, left untreated, they may lead the patient into engaging in riskier behaviors which may lead to the "acquisition and spread of HIV."
The article is reprinted on Medscape (sub. req.).