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Prevalence of psychiatric disorders in a mandatory screening program for infection with human immunodeficiency virus:
J Pace1, G R Brown, J R Rundell
1Department of Psychiatry (SGHMS), Wilford Hall Medical Center, Lackland AFB, TX 78236.
Insights
Psychiatric conditions are common in human immunodeficiency virus (HIV)-seropositive individuals, with simple phobia and hypoactive sexual desire disorder increasing upon HIV knowledge. Integrated psychiatric screening is recommended for HIV programs.
Area of Science:
- Psychiatry
- Infectious Diseases
- Public Health
Background:
- Human immunodeficiency virus (HIV) infection can have significant psychological impacts.
- Understanding the prevalence of psychiatric disorders in HIV-seropositive populations is crucial for comprehensive care.
Purpose of the Study:
- To determine the prevalence of psychiatric disorders in a sample of HIV-seropositive Air Force personnel.
- To identify specific psychiatric conditions that are more common in this population compared to the general population.
Main Methods:
- Psychiatric examination of 95 randomly selected HIV-seropositive Air Force personnel.
- Comparison of disorder frequencies with age-matched Epidemiologic Catchment Area (ECA) participants.
Main Results:
- 95% of participants were asymptomatic for acquired immunodeficiency syndrome (AIDS).
- 61.1% had Axis I diagnoses (e.g., phobias, adjustment disorders, depression, organic mental disorders).
- 30.5% had personality disorders; simple phobia and hypoactive sexual desire disorder were more frequent with HIV knowledge.
- Simple phobia, antisocial personality disorder, alcohol abuse, and organic mental disorders were more common than in ECA participants.
Conclusions:
- A high prevalence of psychiatric illness exists in HIV-seropositive individuals.
- Routine psychiatric screening and counseling should be integrated into HIV screening and management programs.
Abstract:
Ninety-five randomly selected human immunodeficiency virus (HIV)-seropositive Air Force personnel were psychiatrically examined during a routine medical evaluation. Of the 95, 95% did not have acquired immunodeficiency syndrome and were largely asymptomatic; 61.1% had clinical axis I diagnoses, which included simple phobia, adjustment disorders, hypoactive sexual desire disorder, alcohol use disorder, major depression, and organic mental disorders; 30.5% had personality disorders. Significantly higher frequencies (p less than 0.05) of simple phobia and hypoactive sexual desire disorder were noted with knowledge of HIV seropositivity. Disorders that occurred more commonly than in age-matched Epidemiologic Catchment Area (ECA) participants included: simple phobia, antisocial personality disorder, alcohol abuse, and organic mental disorders. The high prevalence of major psychiatric illness in this sample supports the notion that screening for psychiatric illness, and counseling where indicated, should be integral to HIV screening programs.