Human immunodeficiency virus (HIV) infection and quality of life: the potential impact of Axis I psychiatric disorders in a sample of 95 HIV seropositive men.
OBJECTIVE
The purpose of this study is to assess whether Axis I psychiatric disorders exert effects on function and well-being independent of human immunodeficiency virus (HIV)-related disease progression.


METHODS
A convenience sample of 95 HIV seropositive individuals completed the Medical Outcomes Study Short Form Health Survey (SF-20). The Standardized Clinical Interview for DSM-III-R (SCID-NP-HIV) was used to screen subjects for Axis I psychiatric disorders in the previous 6 months. HIV-related disease severity was defined for each subject using the 1993 revised Centers for Disease Control (CDC) Classification System.


RESULTS
Thirty-seven (39%) subjects had asymptomatic HIV disease and 58 (61%) had symptomatic disease. Thirty-three (35%) subjects had Axis I disorders in the previous 6 months. After controlling for HIV-related disease severity, psychiatric disorders were independently associated with substantive decrements in the mental health and health perceptions dimension scores (beta-coefficients were approximately -18.0 for both dimensions; p < or = 0.01). Axis I disorders were also associated with decrements in the social functioning dimension at a p value that approached significance (p = 0.04).


CONCLUSIONS
In HIV seropositive individuals, the presence of an Axis I psychiatric disorder in the previous 6 months is associated with diminished scores in multiple areas of functioning and well-being, independent of HIV-related disease progression. Axis I disorders, therefore, appear to impact quality of life. These findings, in part, suggest that the SF-20 (the mental health subscale, in particular) may have utility as a screening tool for the presence of a recent Axis I diagnosis.
Holmes
W C
WC
Division of General Internal Medicine, University of Pennsylvania Medical School, Philadelphia 19104-6021, USA. holmeswc@mail.med.upenn
Bix
B
B
Meritz
M
M
Turner
J
J
Hutelmyer
C
C
D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000175:diagnosis / Q000523:psychology*; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology* / Q000635:transmission; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs; D011788:Quality of Life; D012803:Sick Role; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology*
D011619:Psychotropic Drugs