Prevalence and comorbidity of psychiatric diagnoses based on reference standard in an HIV plus patient population
Prevalence and comorbidity of psychiatric diagnoses based on reference standard in an HIV plus patient population
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DOI：
10.1097/psy.0b013e31816aa0cc
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发表时间：
2008-05-01
影响因子：
3.3
通讯作者：
Miller, William C.
中科院分区：
文献类型：
--
作者：
Gaynes, Bradley N.;Pence, Brian Wells;Miller, William C.
目的：研究基于参考标准诊断标准的人类免疫缺陷病毒（HIV）患者精神共病的患病率。精神疾病在艾滋病毒感染者中很常见，并与消极的健康行为和较差的临床结果有关。在那些患有精神疾病的人中，精神病合并症（多个同时诊断）与精神病严重程度增加和更高的HIV风险行为有关。研究方法：在美国东南部的一个学术医疗中心，共有152名连续出现HIV+的患者完成了DSM-IV（精神疾病诊断和统计手册，第4版）的改良结构化临床访谈，评估了过去一年和过去一个月的情绪，焦虑和物质使用障碍。结果：分别有50%和33%的患者在过去一年和过去一个月诊断。最常见的诊断是情绪障碍（去年32%/上个月21%），其次是焦虑（21%/17%）和物质使用障碍（22%/11%）。去年有疾病的人中有一半和上个月有疾病的人中有40%符合多重诊断标准。在过去一个月内患有情绪障碍的人中，53%也患有焦虑或物质使用障碍;在患有焦虑障碍的人中，62%也患有情绪或物质使用障碍;在患有物质使用障碍的人中，63%也患有情绪或焦虑障碍。精神科合并症与年龄较小、白色非西班牙裔ace/种族和更高的HIV感染率相关。结论：在这个样本中，情绪、焦虑和物质使用障碍的共病是例外而不是规则。对于有精神病诊断的HIV阳性患者，应考虑潜在的共病性疾病。
Objective: To study the prevalence of psychiatric comorbidity based on reference standard diagnostic criteria in patients with human immunodeficiency virus (HIV). Psychiatric illness is common in patients with HIV and has been associated with negative health behaviors and poorer clinical outcomes. Among those persons with psychiatric illness, psychiatric comorbidity (multiple simultaneous diagnoses) is associated with increased psychiatric severity and higher HIV risk behaviors. Methods: A total of 152 consecutively presenting HIV+ patients at an academic medical center in the southeastern US completed a modified Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition) that assessed mood, anxiety, and substance use disorders in the past year and past month. Results: Fifty percent and 33% of patients had a past-year and past-month diagnosis, respectively. The most common diagnoses were mood disorders (32% past year/21% past month) followed by anxiety (21%/17%) and substance use disorders (22%/11%). Half of those with past-year disorders and 40% of those with past-month disorders met the criteria for multiple diagnoses. Of those with a mood disorder in the past month, 53% also had an anxiety or substance use disorder; of those with an anxiety disorder, 62% also had a mood or substance use disorder; and of those with a substance use disorder, 63% also had a mood or anxiety disorder. Psychiatric comorbidity was associated with younger age, White non-Hispanic ace/ethnicity, and greater HIV symptomatology. Conclusions: Comorbidity of mood, anxiety, and substance use disorders was the exception rather than the rule in this sample. Potential co-occurring disorders should be considered for HIV+ patients presenting with a psychiatric diagnosis.