Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States
Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States
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DOI：
10.1001/archpsyc.58.8.721
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发表时间：
2001-08-01
影响因子：
--
通讯作者：
Shapiro, M
中科院分区：
文献类型：
--
作者：
Bing, EG;Burnam, A;Shapiro, M
背景资料：以前没有关于美国接受人类免疫缺陷病毒（艾滋病毒）疾病护理的成年人中精神障碍和吸毒流行率的全国代表性估计数。也不知道哪些临床和社会人口学因素与这些disorders.Subjects和方法：我们在1996年在美国招募了2864名接受HIV护理的成年人的全国代表性概率样本。参与者接受了一个简短的结构化精神病学仪器，筛选精神疾病（重性抑郁症，心境恶劣，广泛性焦虑症和惊恐发作）和药物使用在过去的12个月。社会人口统计学和临床因素与筛查阳性的任何精神疾病和药物依赖进行了检查，在多变量logistic回归analysis.Results：近一半的样本筛查阳性的精神疾病，近40%的报告使用非法药物大麻以外，超过12%的筛查阳性药物依赖在过去的12个月。与精神疾病筛查阳性相关的独立因素包括HIV相关症状的数量、非法药物使用、药物依赖、重度饮酒以及失业或残疾。与药物依赖筛查阳性的独立相关因素包括许多HIV相关症状，年轻，异性恋，经常大量饮酒，精神疾病筛查阳性。结论：许多感染HIV的人也可能有精神和/或药物依赖障碍。临床医生可能需要积极识别那些有风险的人，并与政策制定者合作，以确保为这些可治疗的疾病提供适当的护理。
Background: There have been no previous nationally representative estimates of the prevalence of mental disorders and drug use among adults receiving care for human immunodeficiency virus (HIV) disease in the United States. it is also not known which clinical and sociodemographic factors are associated with these disorders.Subjects and Methods: We enrolled a nationally representative probability sample of 2864 adults receiving care for HIV in the United States in 1996. Participants were administered a brief structured psychiatric instrument that screened for psychiatric disorders (major depression, dysthymia, generalized anxiety disorders, and panic attacks) and drug use during the previous 12 months. Sociodemographic and clinical factors associated with screening positive for any psychiatric disorder and drug dependence were examined in multivariate logistic regression analyses.Results: Nearly half of the sample screened positive for a psychiatric disorder, nearly 40% reported using an illicit drug other than marijuana, and more than 12% screened positive for drug dependence during the previous 12 months. Factors independently associated with screening positive for a psychiatric disorder included number of HIV-related symptoms, illicit drug use, drug dependence, heavy alcohol use, and being unemployed or disabled. Factors independently associated with screening positive for drug dependence included having many HIV-related symptoms, being younger, being heterosexual, having frequent heavy alcohol use, and screening positive for a psychiatric disorder.Conclusions: Many people infected with HIV may also have psychiatric and/or drug dependence disorders. Clinicians may need to actively identify those at risk and work with policymakers to ensure the availability of appropriate care for these treatable disorders.