Analysis of psychiatric consultations in patients with HIV infection and related syndromes

HIV/AIDS awareness in those diagnosed with mental illness

The spread of human immunodeficiency virus (HIV) continues to increase among the general population. Previous studies in this field focused mainly on the 'at-risk' groups such as homosexuals, prostitutes, intravenous drug users, bisexual men and women. Mentally ill men and women remain one of the subgroups understudied and yet continue to show disproportionately high levels of seroprevalence. The purpose of this study was to elucidate awareness of the risk factors associated with HIV transmission and development of AIDS in those diagnosed with mental illness. Using questionnaires, information regarding HIV method of transmission, knowledge on HIV/AIDS and at-risk behaviour awareness was obtained from 30 subjects in an acute psychiatric mental health unit (13 women and 17 men). Significant association between different variables was determined at 95.5% confidence level (P=0.05). Assessment of HIV/AIDS awareness and at-risk behaviour awareness revealed significant knowledge deficit among this subject group. The outcome of this study underscores the need to introduce intervention programmes tailored to individual needs of the mentally ill. Measures such as 'at-risk sexual' behaviours should be incorporated into the current assessment process or profile so that accurate information and informed judgement can be reached regarding client or patient sexual behaviour.

Suicide probability and psychological morbidity secondary to HIV infection: a control study of HIV-seropositive, hepatitis C virus (HCV)-seropositive and HIV/HCV-seronegative injecting drug users

BACKGROUND

Suicide ideation and psychological morbidity among HIV-positive patients has been the object of intense research. No study has investigated this area among injecting drug users (IDUs) infected with HIV and those infected with the hepatitis C virus (HCV), which has the same patterns of transmission of the HIV and may favour HIV replication and, possibly, HIV disease progression.

METHODS

In order to examine the prevalence and characteristics of suicide ideation and psychological morbidity associated with HIV and HCV infection in IDUs, a sample of HIV+ (n=81), HIV-/HCV+ (n=62) and HIV-/HCV- (n=152) subjects completed the Suicide Probability Scale (SPS), The Brief Symptom Inventory (BSI) and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

No difference was found between the groups as far as the mean scores on SPS and the risk of suicide (no-low risk category: 70.7% HIV+, 56.09% HCV+, 65.6% HIV-/HCV-). Estimated psychological morbidity (BSI) (26.9% HIV+, 27.1% HCV+, 25.4% of HIV-/HCV-) and BSI and HADS scores were comparable across the groups.

CONCLUSIONS

Suicide ideation, psychological morbidity and anxiety and depression symptoms seemed not to be directly influenced by HIV-serostatus. Careful assessment of psychological symptoms and suicide ideas among IDUs, as a vulnerable segment of population at risk of HIV and HCV infections, needs to be routinely carried out in clinical settings.