Psychopathology in male and female intravenous drug users with and without HIV infection. American Journal of Psychiatry, 151, 1662-1668

HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York.
American Journal of Psychiatry (Impact Factor: 12.3). 12/1994; 151(11):1662-8.
Source: PubMed


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.

1 Follower
3 Reads
    • "The significantly higher prevalence of alcohol dependence syndrome confirmed the findings by Rosenberg et al.[23] who reported alcohol as the strongest predictor of HIV drug risk behaviors, stronger than drug use generally. Most patients with substance abuse disorders had developed these disorders before acquiring HIV which is in agreement with earlier report.[48] Substance abusers are prone to have high risk sexual behaviors, as there is a higher rate of non-inhibition, impaired judgment and impulsivity.[149] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background:Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals.Aim:The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients.Materials and Methods:A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically.Results:Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls.Conclusion:Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.
    No preview · Article · Jul 2013 · Industrial psychiatry journal
  • Source
    • "Although many studies have focused on mental health outcomes in childhood maltreatment and HIV separately, there is a paucity of research investigating childhood maltreatment and HIV in combination, and the associated mental health outcomes in dually affected men and women. HIV-infected women may face more current and past negative life events than men in developing parts of the world [13] and this may lead to significant adult psychopathology and poor adherence to antiretroviral medications [24,25]. In light of this, it is evident that HIV-positive individuals, women in particular, are vulnerable to risk factors associated with abuse, and abuse-related changes in behavioral functioning, which may complicate HIV infection. "
    [Show abstract] [Hide abstract]
    ABSTRACT: High rates of childhood maltreatment have been documented in HIV-positive men and women. In addition, mental disorders are highly prevalent in both HIV-infected individuals and victims of childhood maltreatment. However, there is a paucity of research investigating the mental health outcomes associated with childhood maltreatment in the context of HIV infection. The present systematic review assessed mental health outcomes in HIV-positive individuals who were victims of childhood maltreatment. A systematic search of all retrospective, prospective, or clinical trial studies assessing mental health outcomes associated with HIV and childhood maltreatment. The following online databases were searched on 25-31 August 2010: PubMed, Social Science Citation Index, and the Cochrane Library (the Cochrane Central Register of Controlled Trials and the Cochrane Developmental, Psychosocial and Learning Problems, HIV/AIDS, and Depression, Anxiety and Neurosis registers). We identified 34 studies suitable for inclusion. A total of 14,935 participants were included in these studies. A variety of mixed mental health outcomes were reported. The most commonly reported psychiatric disorders among HIV-positive individuals with a history of childhood maltreatment included: substance abuse, major depressive disorder, and posttraumatic stress disorder. An association between childhood maltreatment and poor adherence to antiretroviral regimens was also reported in some studies. A broad range of adult psychopathology has been reported in studies of HIV-infected individuals with a history of childhood maltreatment. However, a direct causal link cannot be well established. Longer term assessment will better delineate the nature, severity, and temporal relationship of childhood maltreatment to mental health outcomes.
    Full-text · Article · Jun 2012 · Systematic Reviews
  • Source
    • "Progression of HIV may also be hastened by mental disorders such as anxiety and depression (Farinpour et al., 2003; Leserman et al., 1999). In addition, research suggests that the burden of mental illnesses among HIV-infected individuals may be significant, predominantly substance, anxiety, and mood disorders , both globally and within South Africa (Demyttenaere et al., 2004; Evans et al., 2002; Lipsitz et al., 1994; Olley, Seedat, Neil, & Stein, 2004; Olley, Zeier, Seedat, & Stein, 2005; Olley et al., 2003). Murray and Lopez (1997) "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Sep 2009 · AIDS Care
Show more