Psychopathology in male and female intravenous drug users with and without HIV infection.
ABSTRACT The authors report on results of systematic clinical assessment of psychopathology among HIV-positive and HIV-negative intravenous drug users.
As part of a multidisciplinary baseline assessment, 147 male (85 HIV-positive and 62 HIV-negative) and 76 female (39 HIV-positive and 37 HIV-negative) intravenous drug users were evaluated with the Structural Clinical Interview for DSM-III-R and measures of psychiatric symptom severity, global functioning, and stress.
Prevalence of a diagnosis of current depression (26%) and severity of depressive and anxiety symptoms in both HIV-positive and HIV-negative subjects were greater than in the general community, but not greater than in other studies of intravenous drug users. HIV-positive men had a higher prevalence of depressive disorders than HIV-negative men (33% and 16%, respectively), although this pattern was not found among women (26% and 30%). Diagnosis of depressive disorders and severity of depressive and anxiety symptoms were associated with a symptom-based measure of HIV illness stage, but not with indices of immune functioning (CD4+ cell count and CD4+ cell percent).
Despite selective associations between HIV illness variables and depression, high rates of depression across HIV status in this cohort suggest that intravenous drug use and associated factors are more salient than HIV illness factors in understanding psychopathology in this population.
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ABSTRACT: It has been suggested that an HIV diagnosis may increase the likelihood of mental disorders among infected individuals and that the progression of HIV may be hastened by mental disorders like anxiety and depression. Therefore, a brief screening measure, with good sensitivity/specificity for psychiatric diagnoses that could be given to HIV-infected individuals would be useful. We assessed the validity of the K-10, using the MINI International Neuropsychiatric Interview as the gold standard, in a sample of 429 HIV-infected adults enrolled in HIV care and treatment services near Cape Town, South Africa. There was significant agreement between the K-10 and the MINI-defined depressive and anxiety disorders. A receiver operating characteristic (ROC) curve analysis indicated that the K-10 showed agreeable sensitivity and specificity in detecting depression (area under the ROC curve, 0.77), generalized anxiety disorder (0.78), and posttraumatic stress disorder (PTSD) (0.77). The K-10 may be a useful screening measure for detecting mood and anxiety disorders, including PTSD, in patients with HIV/AIDS.AIDS Care 09/2009; 21(9):1163-8. DOI:10.1080/09540120902729965 · 1.60 Impact Factor
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ABSTRACT: This pilot study examined rates of major depression and suicidality and their associations with daily functioning in HIV infected (HIV+) and uninfected (HIV-) persons in China. HIV+ participants (N=28) and demographically matched HIV- controls (N=23) completed the Chinese Composite International Diagnostic Interview to determine lifetime rates of major depressive disorder (MDD) and suicidality. Current mood and suicidal ideation were assessed with the Beck Depression Inventory-I. The impact of depression and HIV infection on daily functioning was measured by an Activity of Daily Living questionnaire. Mean duration of known HIV+ status was 2 years. Almost 79% (n=22) of HIV+ but just 4% (n=1) of HIV- groups reported lifetime major depression. Of the 22 HIV+ individuals with lifetime MDD, only one had onset before learning of HIV status. The remainder developed MDD within 6 months after testing HIV positive. In those HIV+ subjects who met MDD criteria after HIV diagnosis, only two (9%) had received depression treatment, yet four (18%) had persisting active suicidal thoughts. Depression and HIV+ status independently predicted worse daily functioning. Representativeness is limited in this small sample of convenience. This preliminary study presents evidence of high rates of major depression and suicidality in HIV-infected persons in China. Despite this, few had sought mental health assistance, suggesting a need to increase awareness of psychiatric comorbidity and access to mental health services.Journal of Affective Disorders 09/2006; 94(1-3):269-75. DOI:10.1016/j.jad.2006.04.013 · 3.71 Impact Factor
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ABSTRACT: Objective: To examine the relations of emotional control and chronic pain to depressive symptomatology in persons with positive human immunodeficiency virus (HIV) status. Study Design: Cross-sectional survey. Participants: One hundred twenty (51 women, 69 men) individuals with serologically documented HIV. Main Outcome Measures: Measures of depressive symptomatology (Center for Epidemiologic Studies-Depression Scale [CES-D]; L. S. Radloff, 1977), emotional control (i.e., inhibited expression of feelings of anger, anxiety, or depression; Courtauld Emotional Control Scale; M. Watson & S. Greer, 1983), and chronic pain. Results: Full multiple regression analysis showed that constant pain, emotional control, and antidepressant use were all significant predictors of (and positively associated with) CES-D total scores. Conclusions: Within comprehensive rehabilitation programs with these patients, pain management is a critical issue. Treatment should address patients' comorbid depressive symptomatology and difficulties with expressing negative emotions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)Rehabilitation Psychology 10/2002; 47(4):402-414. DOI:10.1037/0090-55126.96.36.1992 · 1.91 Impact Factor