Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: A longitudinal evaluation
Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: A longitudinal evaluation
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DOI：
10.1017/s0033291796004552
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发表时间：
1997-03-01
影响因子：
6.9
通讯作者：
Banks, G
中科院分区：
文献类型：
--
作者：
Dew, MA;Becker, JT;Banks, G
背景关于精神疾病的患病率在HIV血清阳性（HIV +）人群中是否高于未感染者的问题，人们几乎没有达成一致意见。然而，由于抽样、研究设计以及未能控制其他疾病风险因素的困难，对该问题的评估受到限制。方法。DSM-III-R重性抑郁症、广泛性焦虑症、适应障碍以及酒精和药物滥用/依赖的患病率和临床特征在指定地理区域的初级保健医生办公室就诊的HIV+男性代表性样本中进行了评估。通过标准化访谈，确定了113名HIV阳性男性和57名HIV阴性男性的基线终生患病率和纵向随访期间的1年患病率。多变量分析考虑了HIV血清状态和其他危险因素对疾病可能性的独特和综合影响。虽然在基线之前，终生患病率没有差异，但在前瞻性研究期间，HIVS男性的疾病风险更大。对于MDD，即使在控制了其他风险因素后，这种效应也得以维持。这些其他因素中有几个有自己的影响：无论HIV血清状态如何，如果在基线时，男性更年轻，有终生精神病史，或社会支持不足或个人主人翁感低，则男性易患精神病理学。某些精神疾病的风险似乎是唯一的高艾滋病毒感染者。由于其他因素也会影响风险，因此旨在尽量减少艾滋病毒感染期间精神病理学的干预措施应兼顾与艾滋病毒相关和非艾滋病毒相关的风险因素。
Background. There is little agreement on whether the prevalence of psychiatric disorder is elevated in HIV-seropositive (HIV +) populations compared with uninfected persons. However, evaluation of this issue has been limited by difficulties of sampling, study design and failure to control for other risk factors for disorder.Methods.Prevalence and clinical characteristics of DSM-III-R major depressive disorder generalized anxiety disorder, adjustment disorder, and alcohol and substance abuse/dependence were evaluated in a representative sample of HIV+ men attending primary care physicians' offices in a defined geographical area. Lifetime prevalence at baseline and 1-year rates during longitudinal follow-up were determined for the 113 HIV+ men, as well as 57 HIV- men, via standardized interview. Multivariate analyses considered unique and combined effects of HIV serostatus and other risk factors on likelihood of disorder.Results. Although there were no differences in lifetime rates prior to baseline, HIVS men were at greater risk for disorders during the prospective study period. For MDD, this effect was maintained even after controlling for other risk factors. Several of these other factors bore their own effects: regardless of HIV serostatus, men were susceptible to psychopathology if at baseline they were younger, had a lifetime psychiatric history, or had poor social supports or a low sense of personal mastery.Conclusions. The risk of certain psychiatric disorders appears uniquely elevated in HIVS men. Since other factors also influence risk, interventions designed to minimize psychopathology during HIV infection should attend to both HIV-related and non-HIV-related risk factors.