Impact of psychiatric conditions on health-related quality of life in persons with HIV infection
Impact of psychiatric conditions on health-related quality of life in persons with HIV infection
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DOI：
10.1176/appi.ajp.157.2.248
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发表时间：
2000-02-01
影响因子：
17.7
通讯作者：
Shapiro, MF
中科院分区：
文献类型：
--
作者：
Sherbourne, CD;Hays, RD;Shapiro, MF
目的：对HIV感染者共病精神症状的影响知之甚少。这项研究估计了在全国有代表性的艾滋病毒感染者样本中，与共病精神疾病相关的健康相关生活质量的负担。方法：作者对城市和农村地区进行了多阶段抽样，以产生美国本土接受医疗护理的艾滋病毒感染者的全国概率样本（N= 2，864）。通过简短的综合国际诊断访谈对受试者进行精神疾病筛查。大量饮酒是根据饮酒的数量和频率进行评估的。健康相关的生活质量是用一个28项的工具来评定的，该工具改编自医学结局研究中使用的类似测量方法。结果如下：有可能被诊断为情绪障碍的HIV受试者在健康相关生活质量指标上的得分明显低于那些没有此类症状的受试者。与健康相关的生活质量下降与大量饮酒无关，在吸毒者中，这是由于存在共病情绪障碍。结论：由于艾滋病毒是一种慢性疾病，有长期存活的前景，因此优化与健康有关的生活质量尤为重要。合并精神疾病可作为艾滋病毒感染者功能和健康受损的标志，让足够数量的受过适当培训的精神卫生专业人员识别和治疗此类疾病，可减少对其他卫生服务的不必要利用，并改善艾滋病毒感染者与健康有关的生活质量。
Objective: Little is known about the impact of comorbid psychiatric symptoms in persons with HIV. This study estimates the burden on health-related quality of life associated with comorbid psychiatric conditions in a nationally representative sample of persons with HIV. Method: The authors conducted a multistage sampling of urban and rural areas to produce a national probability sample of persons with HIV receiving medical care in the contiguous United States (N=2,864). Subjects were screened for psychiatric conditions with the short form of the Composite International Diagnostic interview. Heavy drinking was assessed on the basis of quantity and frequency of drinking. Health-related quality of life was rated with a 28-item instrument adapted from similar measures used in the Medical Outcomes Study. Results: HIV subjects with a probable mood disorder diagnosis had significantly lower scores on health-related quality of life measures than did those without such symptoms. Diminished health-related quality of life was not associated with heavy drinking, and in drug users it was accounted for by presence of a comoribid mood disorder. Conclusions: Optimization of health-related quality of life is particularly important now that HIV is a chronic disease with the prospect of long-term survival. Comorbid psychiatric conditions may serve as markers for impaired functioning and well-being in persons with HIV, Inclusion of sufficient numbers of appropriately trained mental health professionals to identify and treat such conditions may reduce unnecessary utilization of other health services and improve health-related quality of life in persons with HIV infection.