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Psychosomatic Medicine, Vol 59, Issue 2 187-192, Copyright © 1997 by American Psychosomatic Society

ORIGINAL ARTICLES

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

WC Holmes, B Bix, M Meritz, J Turner and C Hutelmyer
Division of General Internal Medicine, University of Pennsylvania Medical School, Philadelphia 19104-6021, USA. holmeswc@mail.med.upenn

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.


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