title: Dual diagnosis vs. triple diagnosis in HIV: a comparative study to evaluate the differences in psychopathology and suicidal risk in HIV positive male subjects.
abstract: BACKGROUND
  The problem of triple diagnosis of HIV, substance abuse and psychiatric disorders is a complex one with difficult solutions. HIV disease progression is affected by substance use as well as psychiatric illness burden due to both direct as well as indirect factors. Continuing substance abuse with poor drug adherence coexists with psychiatric disorders leading to increased morbidity and mortality.
  
  
  METHODS
  A total of 100 HIV positive subjects comprising of two groups each having 50 subjects with and without substance abuse were assessed using detailed history, mental state examination, WHO schedule for clinical assessment in neuropsychiatry (SCAN 2.0) and Beck's Scale for Suicidal Ideation (BSS). Statistical analysis used Chi-Square test, Fischer's exact test, Student's t-test, Pearson's correlation coefficient, univariate and multiple regression analysis, univariate and multiple logistic regression analysis. p-Value<0.05 was considered to denote statistical significance.
  
  
  RESULTS
  Subjects with substance use disorder had higher rates of psychiatric morbidity (52% vs. 24%, 95% CI=0.5200, p<0.05). The rate of antiretroviral therapy default was almost double in subjects with substance abuse, as compared to subjects without substance use. Suicidal risk was significantly increased (p<0.05) in subjects with co-morbid medical disorders but substance abuse did not increase the risk.
  
  
  CONCLUSIONS
  Substance abuse inflicts a much greater burden on HIV positive individuals as compared to subjects without substance use. Concomitant substance abuse resulted in significantly increased duration of illness and psychiatric morbidity.
authors: Department of Psychiatry, Govt. Medical College, Amritsar 143001, India. Electronic address: manushree@outlook.com.
authors: M
authors: M
authors: Gupta
authors: K
authors: K
authors: Kumar
authors: P D
authors: PD
authors: Garg
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D015658:HIV Infections / Q000150:complications* / Q000523:psychology; D006679:HIV Seropositivity / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology
keywords: Dual diagnosis; HIV; Mental disorders; Substance-related disorders; Triple diagnosis