Personality disorders predict onset of Axis I disorders and impaired functioning among homosexual men with and at risk of HIV infection.
BACKGROUND
A longitudinal study was conducted to investigate whether personality disorders (PDs) increase risk for the development of future Axis I disorders and serious functional impairment among human immunodeficiency virus (HIV)-seropositive and HIV-seronegative homosexual men.


METHODS
Baseline assessments of PDs, Axis I disorders and symptoms, and Global Assessments of Functioning were conducted with a community sample of 107 (66 HIV-positive and 41 HIV-negative) homosexual men participating in a longitudinal study with semiannual interviews over 3 years.


RESULTS
Logistic regression analysis indicated that PDs predicted onset of subsequent Axis I disorders after controlling for both HIV status and lifetime Axis I history (adjusted odds ratio, 4.31; P=.01; 95% confidence interval, 1.39 to 13.32). Of the 21 participants with PDs, 16 (76%) were subsequently diagnosed with Axis I disorders on at least one occasion. By contrast, only 36 (42%) of the 86 participants without PDs were subsequently diagnosed with Axis I disorders. Further, 33% of the participants with PDs, in comparison with only 8% of those without PDs, were assigned Global Assessments of Functioning scores of 50 or lower, indicating serious impairment during the postbaseline study period (adjusted odds ratio, 5.70; P<.005; 95% confidence interval, 1.66 to 19.53).


CONCLUSIONS
Personality disorders may contribute to increased risk for onset of Axis I disorders and serious impairment among homosexual men regardless of HIV serologic status.
Johnson
J G
JG
Department of Psychiatry, Columbia University, New York, USA.
Williams
J B
JB
Goetz
R R
RR
Rabkin
J G
JG
Remien
R H
RH
Lipsitz
J D
JD
Gorman
J M
JM
D000328:Adult; D015897:Comorbidity; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology; D010555:Personality Inventory; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors