[Are there factors which maintain a subjective symptom-free psychological state? A study exemplified with...

In the absence of curative treatment, the diagnosis of HIV infection imposes a heavy burden. Infected persons are therefore confronted with psychological, social and physical problems and cope with them via different strategies and social resources. We investigated the question of what factors help to maintain a psychologically symptom-free state.

A sample of 117 asymptomatic HIV-infected persons was recruited out of the Swiss HIV Cohort Study (Part A) in 1989 and 1990. The psychological symptoms were assessed with a self-rating questionnaire (SCL-90-R). The structured interview focused on social network, social support (SONET), and coping strategies (FEKB).

79% of the asymptomatic persons did not report psychological symptoms. In multivariate analyses, "rumination" (= preoccupational thinking), female gender, and affectively negative relationships correlated with more, but affectively positive relationships and the strategy "defence against threat" with fewer, psychological symptoms. Additionally, there was no significant correlation between the immunological markers (CD4-, CD8-cell count, p24 antigen) and psychological complaints.

The low number of asymptomatic HIV-infected persons with psychological symptoms (21%) is in accordance with other studies. Psychological symptoms and rumination correlate significantly in our sample. As rumination is difficult to recognize, HIV-infected patients should be directly questioned about rumination and their defence against threat should be supported in order to prevent the development of psychological symptoms.