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Alleviating HIV symptoms is critical for patients' mental health

Although people infected with the human immunodeficiency virus (HIV) are much more likely to suffer from anxiety or depression than the general population, living with HIV does not necessarily lead to increased psychiatric distress, according to a new study. Nevertheless, relief of HIV symptoms is paramount to patients' mental health.

Researchers led by Aram Dobalian, Ph.D., J.D., of the University of Florida, Gainesville, examined the potential impact of clinical factors (for example, HIV symptoms, CD4 cell count, and/or a diagnosis of AIDS) and sociodemographic factors on the persistence or new development of generalized anxiety disorder (GAD), panic disorder (PD), major depressive disorder (MDD), and dysthymia (DYS) over a 6-month period. For the analysis, Dr. Dobalian and his colleagues used data from the HIV Cost and Services Utilization Study (HCSUS), a nationally representative sample of people in the United States under care for HIV. HCSUS is supported in part by the Agency for Healthcare Research and Quality (HS08578).

Of the 2,864 patients studied, baseline anxiety and depression were highly prevalent (GAD, 16 percent; PD, 11 percent; MDD, 36 percent; and DYS, 27 percent). Fewer patients exhibited anxiety or depression 6 months later (GAD, 11 percent; PD, 9 percent, MDD, 28 percent, and DYS, 21 percent).

Of the clinical factors, baseline HIV symptom count was associated with increased likelihood of each condition at followup. In addition, an increase in the number of HIV symptoms from baseline to followup predicted greater likelihood of screening positive for all conditions at followup. Symptoms may be a salient and constant reminder that one has the disease, and many HIV-related symptoms are painful and debilitating, which may in turn lead to increased anxiety, depression, or both. On the other hand, pre-existing psychiatric distress may amplify symptom perception or report.

See "Stability of anxiety and depression in a national sample of adults with human immunodeficiency virus," by Jennie C. Tsao, Ph.D., Dr. Dobalian, Charles Moreau, M.D., and Kendra Dobalian, M.D., in the February 2004 Journal of Nervous and Mental Disease 192(2), pp. 111-118.

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