HIV-related symptoms and psychological functioning in a cohort of homosexual men

Article Abstract:

Many people in high risk groups for AIDS experience a chronic state of concern about physical and emotional symptoms that might be associated with the disease. The serologic test that indicates the presence of the human immunodeficiency virus (HIV) lacks prognostic ability and cannot contribute any hope along with the diagnosis. The nonspecific nature of the symptoms further complicates living with the risk of developing AIDS. The Center for Epidemiological Studies Depression (CES-D) Scale was given to 4,954 homosexual men who were part of an AIDS cohort study and who considered themselves at high risk. Also included were questions regarding their overall sense of well-being and the number of persons available to discuss their personal problems with. A control population of married men was also evaluated. Thirty-eight percent of the homosexual men were found to be seropositive for HIV and generally had higher depression scores than the married men. Self-reported HIV-related symptoms and inadequate support networks were associated with higher psychological symptom scores, regardless of HIV status; HIV seropositivity was not independently associated with high CES-D scores. Many seropositive and seronegative men reported having one or more possible HIV-related physical symptom in the prior six months. Men who were bisexual had higher depression scores than those who were exclusively homosexual; younger men and men with a lower socioeconomic status reported more symptoms. Men who reported more than three possible HIV-related symptoms had double the depression scores of those reporting no symptoms. Individuals testing positive for HIV were more likely to perceive swollen lymph glands, which were not always associated with the findings on physical exam. Approximately 22 percent of the cohort men had used prescription psychotropic drugs during the prior six months, which corresponded with higher depression scores. Psychological distress was associated with the perceived risk of AIDS and the lack of someone to talk to about serious problems, rather than actual HIV status. The psychological symptoms reported by these men did not necessarily correlate with HIV infection, therefore these symptoms cannot be used to predict future risk of AIDS development. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Depression, Mental, Depression (Mood disorder)

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Psychosocial distress and well-being among gay and bisexual men with human immunodeficiency virus infection

Article Abstract:

The psychosocial effects of infection with HIV (human immunodeficiency virus, the virus responsible for AIDS) were examined in a sample group composed of 65 bisexual or gay men. The individuals were divided into three subgroups and profiles of their levels of psychosocial distress and well-being were assessed with current life stress, social network support, and demographic factors in mind. The subgroups, representing the three general phases of the HIV infection, were broken down as follows: 24 with asymptomatic HIV infection; 22 with ARC (AIDS-related complex); and 19 with full-blown AIDS. Typically, individuals in all of these categories undergo the stress of the tangible physical threat of the terminal illness, as well as the additional element of social rejection and ostracism. It may be a relevant factor that all of the individuals in this study were treated under the socialized Canadian health care system, which incorporates a fairly extensive network of social service organizations. High levels of distress were reported by the majority of the participants. The group with asymptomatic HIV infection and the group with AIDS-related complex had levels of distress that were significantly higher than in the group with AIDS. The feelings of social well-being recorded did not follow this pattern and results seemed to be independent of the degree of distress. There were minor variations within the subgroups, but overall, most of the individuals reported a fairly balanced experience of positive and negative effects from the illness with regard to feelings of well-being. The importance of separately examining the two psychosocial aspects of distress and well-being was reinforced as the two factors were not found to be mutually exclusive. No definitive conclusions on the frequency of suicide in HIV-infected individuals could be reached. The investigators concluded that there exists a need for a better identification of specific needs according to the stage of illness in HIV-infected individuals.

Analysis, Physiological aspects, HIV (Viruses), HIV, Stress (Psychology), Anxiety

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Study of 60 patients with AIDS or AIDS-related complex requiring psychiatric hospitalization

Article Abstract:

A group of 60 patients with AIDS (acquired immunodeficiency syndrome) or ARC (AIDS-related complex) showing a wide variety of mental disorders were observed for 30 months while they were treated in a locked inpatient psychiatric unit. The normal criteria for diagnosis were waived, as all of the patients had underlying organic disorders. It was impossible to determine if the origin of their mental disorders was a direct or indirect result of the human immunodeficiency virus infection (HIV), independent of the infection, or a combination of factors. It was concluded that the infection most likely was a factor in their mental disturbance because 60 percent of these individuals were first hospitalized after becoming infected with the virus. The study was limited, however, by a number of factors: few clinical details, possible bias because only one researcher collected and analyzed the data, and lack of follow-up data. Patients suffering from depression responded well to the hospitalization and the results emphasized the importance of psychosocial interventions. Mood swings were frequent and dramatic, and accompanied by transient episodes of suicidal thoughts. It was concluded that suicide intervention was necessary and advisable for this group. Preliminary studies have shown that treatment with drugs, specifically psychostimulants, to check or prevent HIV dementia has produced some positive results. Therapy with zidovudine (AZT) proved superior to haloperidol, which created more side effects. In general, the lack of sub-acute care facilities has resulted in the over use of acute-care units. Because the number of HIV-infected individuals is on the rise, greater demand for appropriate treatment centers will continue. Suggestions for further research include the identification of biological markers connected with mental disorders and the development of effective drug therapies.

Causes of, Mental illness, Mental disorders

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