Persistence of psychiatric disorders in a cohort of HIV/AIDS patients in South Africa: A 6-month follow-up study
Persistence of psychiatric disorders in a cohort of HIV/AIDS patients in South Africa: A 6-month follow-up study
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DOI：
10.1016/j.jpsychores.2006.03.010
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发表时间：
2006-10-01
影响因子：
4.7
通讯作者：
Stein, Dan J.
中科院分区：
文献类型：
--
作者：
Olley, Benjamin O.;Seedat, Soraya;Stein, Dan J.
背景：HIV/AIDS患者的精神障碍很常见，在诊断后不久或在随后的病程中出现。然而，很少有前瞻性研究的精神疾病在HIV/AIDS的发病率，特别是在发展中国家的背景下，最近诊断的HIV的65例患者接受了采访，介绍到医院的艾滋病诊所，然后6个月后。在这两次访谈中，使用MINI国际神经精神访谈，Carver Brief科普和Sheehan残疾量表对患者进行评估。暴露于负性生活事件和危险行为evaluated.Results：在随访期间的精神疾病的总体患病率仍然很高（56%的患者至少有一个精神疾病在基线，和48%的患者至少有一个精神疾病在6个月）。抑郁症和创伤后应激障碍（PTSD）是基线（34.9%和14.8%）和随访（26%和20%）时最常见的疾病。超过一半的基线抑郁患者得到改善（29例中的16例; 55.1%）。然而，在随访中，抑郁症（49例中的4例; 8.1%）和PTSD（17例中的12例; 70.5%）都新发。在单变量分析中，随访时抑郁与以下因素显著相关：（a）工作/社会/家庭功能障碍，（B）负性生活事件数量增加，（c）CD 4淋巴细胞计数下降。单变量分析还显示，PTSD的诊断与（a）较长的感染持续时间和（B）工作/社会/家庭功能的基线残疾显著相关。然而，在多变量分析中，只有残疾评分预测诊断的抑郁症和创伤后应激障碍的后续评估。还注意到危险性行为的持续存在，在随访中报告不使用避孕套的参与者人数明显增加。出现了一个转变，从适应不良的应对行为，更适应的应对行为在6个月period.Conclusion：HIV/AIDS患者的精神障碍的比率是一致的，随着时间的推移。这些研究结果强调了定期评估艾滋病毒/艾滋病患者精神障碍的重要性，不仅在治疗开始时，而且在随后的随访中。(c)2006年由Elsevier Inc.出版
Background: Psychiatric disorders in HIV/AIDS are common, emerging soon after diagnosis or during the subsequent course of illness. However, there are few prospective studies on the rates of psychiatric disorders in HIV/AIDS, particularly in the context of the developing world.Methods: Sixty-five patients with recently diagnosed HIV were interviewed on presentation to a hospital-based HIV clinic and then 6 months later. On both interviews, the patients were assessed using the MINI International Neuropsychiatric Interview, the Carver Brief COPE, and the Sheehan Disability Scale. Exposure to negative life events and risk behaviors was also evaluated.Results: The overall prevalence of psychiatric disorders in the follow-up period remained high (56% of patients had at least one psychiatric disorder at baseline, and 48% of patients had at least one psychiatric disorder at 6 months). Depression and posttraumatic stress disorder (PTSD) were the most prevalent disorders at both baseline (34.9% and 14.8%) and follow-up (26% and 20%), respectively. More than half of all patients with depression at baseline improved (16 of 29; 55.1%). However, there was a new onset of both depression (4 of 49; 8.1%) and PTSD (12 of 17; 70.5%) on follow-up. In univariate analysis, depression on follow-up was significantly associated with: (a) disability in work/social/family functioning, (b) greater number of negative life events, and (c) a decline in CD4 lymphocyte count. Univariate analysis also revealed that a diagnosis of PTSD on follow-up was significantly associated with (a) a longer duration of infection and (b) baseline disability in work/social/family functioning. However, in multivariate analysis, only disability scores predicted the diagnoses of major depression and PTSD on follow-up assessment. Persistence of risky sexual behaviour was also noted, with a significantly higher number of participants reporting nonuse of condom on follow-up. There appeared to be a shift from maladaptive coping behaviors to more adaptive coping behaviors over the 6-month period.Conclusion: The rate of psychiatric disorders in HIV/AIDS patients was consistent over time. These findings emphasize the importance of regular evaluation for psychiatric disorders in HIV/AIDS patients, not only at the commencement of treatment but also during subsequent follow-up visits. (c) 2006 Published by Elsevier Inc.