Prevalence of Psychiatric Disorders Among Men Infected With Human Immunodeficiency Virus: A Controlled Study

doi:10.1001/archpsyc.1988.01800330091011

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Vol. 45 No. 9, September 1988

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Prevalence of Psychiatric Disorders Among Men Infected With Human Immunodeficiency Virus

A Controlled Study

J. Hampton Atkinson, Jr, MD; Igor Grant, MD; Caroline J. Kennedy, MD; Douglas D. Richman, MD; Stephen A. Spector, MD; J. Allen McCutchan, MD

Arch Gen Psychiatry. 1988;45(9):859-864.

Abstract

• We used structured diagnostic interviews and rating scalesto assess lifetime prevalence of psychiatric disorders, by DSM-IIIcriteria, among an unselected sample of 56 ambulatory homosexualmen in four groups: men with acquired immunodeficiency syndrome(AIDS), men with AIDS-related complex (ARC), men asymptomaticor mildly symptomatic but seropositive for antibody to humanimmunodeficiency virus (HIV), and HIV-seronegative men. An age-and demographically matched comparison group of 22 healthy,heterosexual controls was also studied. The homosexual men hadlifetime rates of alcohol or nonopiate drug abuse (22/56 [39.3%]),generalized anxiety disorder (22/56 [39.3%]), and major depression(17/56 [30.3%]) that often preceded diagnosed medical illnessor knowledge of HIV status. The six-month point prevalence ofthese disorders in homosexual men was also high, especiallyalcohol abuse in patients with AIDS-related complex, and theoccurrence of a DSM-III disorder within the previous six monthssignificantly exceeded that in heterosexual controls. The datasuggest that there may be a higher prevalence of anxiety disorderand major depressive illness in homosexual men when comparedwith sociodemographically matched heterosexual men and thatthe psychiatric morbidity may have preceded the onset of theAIDS epidemic. These findings indicate that awareness of psychiatrichistory is necessary to comprehensive medical care of men athigh risk for AIDS, even among relatively healthy outpatients.

Author Affiliations

From the Departments of Psychiatry (Drs Atkinson and Grant), Medicine (Drs Kennedy, Richman, and McCutchan), Pathology (Dr Richman), and Pediatrics (Dr Spector), University of California San Diego School of Medicine, La Jolla; and the Psychiatry (Drs Atkinson and Grant), Laboratory (Dr Richman), and Medical (Dr Richman) Services, San Diego Veterans Administration Medical Center.

Footnotes

Accepted for publication June 14, 1988.

Presented in part at the 140th Annual Meeting of the AmericanPsychiatric Association, Chicago, May 12, 1987.

Reprint requests to Department of Psychiatry, M-003, UCSD Schoolof Medicine, La Jolla, CA 92093 (Dr Atkinson).

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