Abstract
ObjectivesHIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60%) are homosexual men.The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms.MethodsWe compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study) and with non-HIV infected mental health patients (NESDA-study). DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms.ResultsDepressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group.ConclusionHabitual drug use is a risk factor for spreading HIV. It is also more often diagnosed in HIV-infected homosexual men with a lifetime depression or dysthymic disorder than in the non-infected population. Untreated mental health problems, such as depressive symptoms and use of drugs can have serious repercussions. Therefore, general practitioners and internists should be trained to recognize mental health problems in HIV-infected patients.
Highlights
HIV is a highly stigmatized, chronic disease with a substantial co-occurrence of mental health problems [1]
HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men
Habitual drug use is a risk factor for spreading HIV. It is more often diagnosed in HIV-infected homosexual men with a lifetime depression or dysthymic disorder than in the non-infected population
Summary
HIV is a highly stigmatized, chronic disease with a substantial co-occurrence of mental health problems [1]. Patients with mental health problems are at increased risk of contracting HIV. HIV-infected patients are at increased risk of developing mental health problems compared with the general population [2]. Mental health problems in HIV-infected patients have a negative influence on the treatment, adherence to treatment, and prognosis of the HIV-infection [3,4]. There are some important differences between HIV and other chronic diseases. HIV-infected patients suffer more from shame, stigma, and discrimination, which can cause mental health problems [7,8]. Mental health problems in HIVinfected patients can affect public health. Psychopathology like depression and substance abuse can increase hazardous sexual behaviour and, with it, the chance of spreading HIV [9,10]
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