Depressive Disorder and HIV Disease: An Uncommon Association

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Depressive Disorder and HIV Disease: An Uncommon Association

Focus (08/95) Vol. 10, No. 9, P. 1
Rabkin, Judith G.; Remien, Robert H.

Despite the perception that HIV infection may cause depression, evidence suggests that there is seldom a cause-and -effect relationship between the two, write Rabkin and Remien- -both professors of psychology at the College of Physicians and Surgeons at Columbia University. Early reports of psychiatric morbidity among HIV-infected individuals revealed extremely high rates of symptomatic depression and anxiety. However, more recent studies show rates among seropositive gay men, for example, to be about the same those of seronegative gay men. It is important to note that most HIV-infected persons will probably experience bouts of sadness and distress --often in relation to the illness or death of friends--but this is to be expected. Diagnosis of depression may be hampered by the fact that both it and HIV produce similar somatic or physical symptoms, including fatigue, lethargy, low appetite, and weight loss. Some have suggested, but not confirmed, that HIV itself causes mood shifts and that HIV- related dementia causes depression. There is little proof, however, to back up either of these theories. In general, most evidence does not support "a measurable or substantial effect" of psychosocial factors such as depression or stress "on [enumerative measures of] the immune system in relation to physical disorders such as AIDS." While it is understandable that therapists might think that individuals faced with disability, pain, and death could become depressed, the assumption that clinical depression affects all or the majority of HIV-infected persons is wrong, the authors state. Statistics show that the disorder is no more common among HIV- positive individuals than uninfected persons, and is not likely to increase as the disease progresses.

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