Specific Psychological Interventions Research Articles

Intrathecal administration of Nusinersen in type 1 SMA: successful psychological program in a single Italian center.

Nusinersen is the first approved drug to treat spinal muscular atrophy (SMA). Its periodic intrathecal delivery may cause psychological burden in infants and in their parents. We report our experience during expanded access program (EAP) for type 1 SMA in a single Italian center. Because of the occurrence of stress emotional states, anxious reactions and fear before, during, and after lumbar puncture (LP), a specific psychological intervention was implemented based on regulation of emotions, anticipatory expectations, and post-event attributions. Activities included the use of fairy tales, distraction, music play through listening preferred cartoon themes in the youngest children, and contextual games and solution of fun riddle quizzes in the oldest ones. State anxiety greatly reduced in children and their parents. Treatment of psychological aspects should therefore become an integral part of health care in SMA infants and children during Nusinersen treatment.

Illness perception in patients with migraine: An exploratory study in a tertiary care headache centre

BackgroundIllness perception is significantly related to several outcome measures in different medical conditions. However, little is known about headache-related causal attributions and cognitive and emotional representations in patients with migraine. ObjectiveTo examine perceived causes of headache and demographic, clinical, and psychological correlates and predictors of illness perception in patients with migraine attending a tertiary care headache centre. MethodsA sample of 143 patients with migraine (85.3% women, mean age 44.0 ± 12.1 years) completed the Brief Illness Perception Questionnaire (Brief IPQ), the Symptom Questionnaire (SQ), and the Migraine Disability Assessment (MIDAS) Questionnaire. A set of demographic and clinical characteristics was also collected. ResultsStress, heredity, and nervousness were the most frequent perceived causes of headache. Female gender was significantly related to higher Brief IPQ “consequences” and “emotional response” scores. Increased psychological distress and a poorer clinical course were significantly associated with more negative illness representations. In multiple regression analysis, a longer illness duration, increased depressive symptoms, and higher levels of headache-related disability and painfulness of headache attacks independently predicted a worse illness perception. ConclusionsIn patients with migraine, depressive symptoms and a worse disease status, characterized by a longer history of suffering, higher disability and more painful headache attacks, may negatively affect illness perception. It could also be that dysfunctional illness representations lead to depressive symptoms and decrease patients' motivation to adhere to treatments, resulting in a worse outcome. Future studies should examine whether the improvement of illness perception through specific psychological interventions may promote a better adaptation to migraine.

Diminished emotional expression in schizophrenia: an interdisciplinary approach based on behavioral interventions.

Negative symptoms represent the main cause of disability in schizophrenia, having recently been grouped into two general dimensions: avolition and diminished emotional expression, which includes affective flattening and alogia. The aim of this study was to explore the response of these two symptoms to a set of behavioral interventions based on contingency management, performed in an interdisciplinary context. Behaviors of interest were monitored and evaluations before and after the treatment were performed on 9 schizophrenic inpatients with persistent negative symptoms. The program included 12 group double sessions aimed at developing facial expression and verbal communication, and a nursing care plan to generalize and strengthen these behaviors synergistically. there were appreciable differences in facial expression, which were less clear for alogia. The clinical evaluation using PANSS-N did not find notable differences at group level, but the nursing assessment using NOC indicators did. although difficult to modify, negative symptoms are not insensitive to the influence of behavioral interventions. Specific psychological interventions that address negative symptoms as a priority focus of attention and care need to be promoted and developed, particularly when considering the crucial role of context in their progression.

The Recovery from Alcohol Consumption: Analysis of the Construct of Relapse.

Objective: A systematic review was conducted to identify definitions that facilitated the study of relapse as both behavioral pattern and process.Methods: The review was conducted following the PRISMA-P guidelines. Articles that met the following inclusion criteria were considered: (a) published in peer-reviewed journals, (b) provided an explicit operational definition of relapse, (c) assessed relapse during or after a specific psychological or self-care group intervention, (d) focused on alcohol consumption, and (e) were published between 2000 and September 2016.Results: "Any drinking" was the most frequent outcome used to identify relapse, although other discrete outcomes were also considered. Nevertheless, none of the definitions operationalize the notion of the return to a problematic drinking pattern and/or the process of relapse.Conclusion: Problems related to any drinking definition are discussed and we propose the use of a composed index to study relapse.

Characteristics of feeding tube dependency with respect to food aversive behaviour and growth

The use of feeding tubes in pediatric medical procedures and management has dramatically increased over the last three decades. With this increase, the prevalence of Feeding Tube Dependency (FTD) – a reliance on enteral feeding following medical recovery due to lack of oral intake of nutrition, despite being able to eat– has increased too. It has been suggested, that cases with FTD show avoidant feeding behaviours such as food refusal, gagging or swallowing resistance, but evidence for this hypothesis is scarce. In a German population of 146 cases requesting feeding tube dependency treatment between 2005 and 2008 the frequency of occurrence of avoidant behaviour in FTD cases has been evaluated and was correlated to growth. The study includes children under 50 months of age being tube fed for at least three months. Parents received the Anamnestic Questionnaire for Feeding Disorder and Tube Weaning (AFT), which evaluates nutritional supply, tube feeding, feeding disorder symptoms, medical diagnosis, growth and psychosocial variables. The study group was comprised of 101 children (50 male, 51 female), with a median age of 15 months (IQR: 10–26.5) and a median tube feeding duration of 13 months (IQR: 8–27). The most prevalent medical diagnoses were congenital malformations (n = 51) and prematurity (n = 27). Parents reported daily symptoms of food aversion through all age groups, like food refusal 2 (IQR: 1–3), gagging 1 (IQR: 0–3), vomiting 1 (0.1–2) and total symptoms 6 (5–11). Vomiting was negatively correlated with weight and length percentile and head circumference. Cases with FTD show frequent and persistent food avoidant behaviors, which may be explain the need for specific psychological treatment during transitioning from tube dependency to oral eating.

The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis.

This meta-analysis examined the efficacy of cognitive-behavioral therapy (CBT) for eating disorders. Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record

Mental health care for adult refugees in high-income countries.

Approximately one-third of people who have obtained refugee status live in high-income countries. Over recent years, the number of refugees has been increasing, and there are questions on how many of them need mental health care and which type of interventions are beneficial. Meta-analyses showed highly variable rates of mental disorders in adult refugees. This variability is likely to reflect both real differences between groups and contexts, and methodological inconsistencies across studies. Overall prevalence rates after resettlement are similar to those in host populations. Only post-traumatic stress disorder (PTSD) is more prevalent in refugees. In long-term resettled refugees, rates of anxiety and depressive disorders are higher and linked to poor social integration. Research on mental health care for refugees in high-income countries has been extensive, but often of limited methodological quality and with very context-specific findings. The existing evidence suggests several general principles of good practice: promoting social integration, overcoming barriers to care, facilitating engagement with treatment and, when required, providing specific psychological treatments to deal with traumatic memories. With respect to the treatment of defined disorders, only for the treatment of PTSD there has been substantial refugee-specific research. For other diagnostic categories, the same treatment guidelines apply as to other groups. More systematic research is required to explore how precisely the general principles can be specified and implemented for different groups of refugees and in different societal contexts in host countries, and which specific interventions are beneficial and cost-effective. Such interventions may utilise new communication technologies. Of particular importance are long-term studies to identify when mental health interventions are appropriate and to assess outcomes over several years. Such research would benefit from sufficient funding, wide international collaboration and continuous learning over time and across different refugee groups.

Reward-related decision making and long-term weight loss maintenance

BackgroundHeightened sensitivity towards reward and insensitivity towards disadvantageous consequences may constitute a driving factor underlying unrestricted food intake and consequent weight gain in people with overweight and obesity. Therefore, the present study applied a behavioral economics approach to investigate the potential contribution of poor reward-related decision making to unsuccessful long-term weight loss maintenance (i.e. weight cycling). Based on previous research, it was expected that successful long-term weight loss maintainers would show a better performance in a gambling task than their less successful counterparts. MethodsReward-related decision making was assessed post hoc using the Game of Dice Task in a total of 33 overweight and obese women who had either (a) successfully maintained initial weight loss of at least 10% of their body weight over one year or (b) had regained weight until at least their initial body weight prior to weight reduction (i.e. showed weight cycling). ResultsThe groups did not differ in terms of age, current body weight, magnitude of initial weight reduction, educational level, and global intelligence level. As hypothesized, however, the group of successful long-term weight loss maintainers performed significantly better (i.e. showed less impulsive, more advantageous choices) in the Game of Dice Task than their less successful counterparts. ConclusionsThe findings suggest that poor reward-related decision making is associated with weight cycling which is considered a key concern in weight loss treatments for overweight and obesity. Furthermore, the findings speak in favor of specific psychological interventions that are designed to bolster reward-related decision making.

The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets, violence risk and aggressive behaviour in a sample of mentally disordered offenders

This study examined the impact of an intensive inpatient violent offender treatment programme, Life Minus Violence-Enhanced (LMV-E), on intermediary treatment targets, risk for violence, and aggressive behaviour during treatment in a sample of male mentally disordered offenders. Using quasi-experimental design, offenders who completed LMV-E and a comparison group showed reduced problems with impulsivity and anger regulation and improvements in social problem solving. Aggregate risk for future violence lessened in both treatment and comparison groups, although by a significantly greater degree for the comparison group. The aggressive behaviour of both groups reduced. Completion of the LMV-E conferred additional improvements in some facets of social problem solving and anger regulation. Neither group showed improvements in empathic responses, coping skills or problematic interpersonal style. Overall, these results suggest anger regulation, impulsivity and social problem solving are most amenable to change, that reductions in certain facets of these dynamic risk factors transpires with nonspecific psychiatric inpatient treatment, but that the LMV-E, a cognitive behavioural violence specific psychological treatment, confers greater change in some facets of social problem solving and anger regulation.

Scaling Up Psychological Treatments: A Countrywide Test of the Online Training of Therapists

BackgroundA major barrier to the widespread dissemination of psychological treatments is the way that therapists are trained. The current method is not scalable.ObjectiveOur objective was to conduct a proof-of-concept study of Web-centered training, a scalable online method for training therapists.MethodsThe Irish Health Service Executive identified mental health professionals across the country whom it wanted to be trained in a specific psychological treatment for eating disorders. These therapists were given access to a Web-centered training program in transdiagnostic cognitive behavior therapy for eating disorders. The training was accompanied by a scalable form of support consisting of brief encouraging telephone calls from a nonspecialist. The trainee therapists completed a validated measure of therapist competence before and after the training.ResultsOf 102 therapists who embarked upon the training program, 86 (84.3%) completed it. There was a substantial increase in their competence scores following the training (mean difference 5.84, 95% Cl –6.62 to –5.05; P<.001) with 42.5% (34/80) scoring above a predetermined cut-point indicative of a good level of competence.ConclusionsWeb-centered training proved feasible and acceptable and resulted in a marked increase in therapist competence scores. If these findings are replicated, Web-centered training would provide a means of simultaneously training large numbers of geographically dispersed trainees at low cost, thereby overcoming a major obstacle to the widespread dissemination of psychological treatments.

Exploring the form of change: A latent growth curve model of distress in oncologic patients undergoing specific cancer-related psychological intervention—A preliminary study.

e21556 Background: Psychological distress is one of the most important indexes of suffering in oncological patients – due to its severe negative impacts on medical treatments. Thus, the attention to this topic has increased constantly – focusing on the observed outcomes of (psychological) cares. However, very few studies investigated the (latent) pattern ( form) of change in distress within oncological patients receiving psychological intervention. The aim of the study was to test a Latent Growth Curve Model to explore the form of change in distress. Methods: A longitudinal research design was used. Patients ( N= 122, mean age: 68.3, SD= 12.3, 63 female-59 male) were enrolled at the Department of Medical Oncology at Presidio Ospedaliero of Saronno, ASST Valle Olona, Italy, and assessed for the presence of distress with Psychological Distress Inventory (PDI). As clinical routine, all patients received a specific cancer-related psychological intervention (CBT, mainly; mean of sessions: 27.4, SD= 13.5) and were tested at the beginning (T1; α= .88) and at the end of treatment (T2; α= .86) and at timed-balanced follow-up (T3; α= .87). Results: First, longitudinal invariance of measurement was performed to test whether (A) factor structure of PDI and (B) factor loadings of indicators were constant across time. PDI showed metric measurement invariance: Δχ2= 20.4; Δχ2 df= 24; p(Δχ2) = 0.67. Afterward, a LGCM was performed testing different trends of growth (no growth vs. linear vs. free) – controlling for age, number of sessions received, type and localization of tumor. The comparison of growth curves reveal that the linear trends of change had the best model fit to the data: χ2= 4.124, p= .248; RMSEA = .055(.000–.171), p(RMSEA &lt; .05) = .372, CFI = .990, SRMR = .027. Conclusions: These findings highlight that the (latent) linear growth better explain true change of distress – among oncological patients receiving a specific cancer-related psychological intervention. These results outline the possibility to improve the structure of psychological and medical treatments for oncological settings, to reduce psychological suffering and increase quality of life.

Psychological interventions for coronary heart disease.

Psychological interventions can form part of comprehensive cardiac rehabilitation programmes (CCR). These interventions may include stress management interventions, which aim to reduce stress, either as an end in itself or to reduce risk for further cardiac events in patients with heart disease.To determine the effectiveness of psychological interventions, in particular stress management interventions, on mortality and morbidity, psychological measures, quality of life, and modifiable cardiac risk factors, in patients with coronary heart disease (CHD).We searched CCTR to December 2001 (Issue 4, 2001), MEDLINE 1999 to December 2001 and EMBASE 1998 to the end of 2001, PsychINFO and CINAHL to December 2001. In addition, searches of reference lists of papers were made and expert advice was sought.RCTs of non-pharmacological psychological interventions, administered by trained staff, either single modality interventions or a part of CCR with minimum follow up of 6 months. Adults of all ages with CHD (prior myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty, angina pectoris or coronary artery disease defined by angiography). Stress management (SM) trials were identified and reported in combination with other psychological interventions and separately.Studies were selected, and data were abstracted, independently by two reviewers. Authors were contacted where possible to obtain missing information.Thirty six trials with 12,841 patients were included. Of these, 18 (5242 patients) were SM trials. Quality of many trials was poor with the majority not reporting adequate concealment of allocation, and only 6 blinded outcome assessors. Combining the results of all trials showed no strong evidence of effect on total or cardiac mortality, or revascularisation. There was a reduction in the number of non-fatal reinfarctions in the intervention group (OR 0.78 (0.67, 0.90), but the two largest trials (with 4809 patients randomized) were null for this outcome, and there was statistical evidence of publication bias. Similar results were seen for the SM subgroup of trials. Provision of any psychological intervention or SM intervention caused small reductions in anxiety and depression. Few trials reported modifiable cardiac risk factors or quality of life.Overall psychological interventions showed no evidence of effect on total or cardiac mortality, but did show small reductions in anxiety and depression in patients with CHD. Similar results were seen for SM interventions when considered separately. However, the poor quality of trials, considerable heterogeneity observed between trials and evidence of significant publication bias make the pooled finding of a reduction in non-fatal myocardial infarction insecure.

Test anxiety and learned helplessness is moderated by student perceptions of teacher motivational support

The aim of the present study was to examine the interplay between test anxiety (i.e. worry and emotionality) and learned helplessness in a sample of adolescents (N = 845, aged 13–17 years) in secondary schools in Germany. In accordance with the buffering hypothesis, it was hypothesised that the detrimental association between both components of text anxiety and helplessness in school would be buffered by students’ perception of their teachers as positive motivators (TPM). TPM refers to student motivation within the academic context, which results from their perception of teacher support. Interesting differences between the two components of test anxiety were identified: emotionality was positively associated with helplessness in school, whereas worry was negatively associated. Using latent moderated structural equations (LMS), the findings revealed that TPM functions as a moderator in the interplay between emotionality and learned helplessness. Despite these results, TPM did not operate as a buffer between emotionality and learned helplessness since helplessness in school was the highest when students perceived some degree of TPM. These findings make a case for implementing specific psychological interventions within the school context in order to prevent helplessness in school.

A Case Series Evaluation of a Pilot Group Cognitive Behavioural Treatment for Children With Asthma and Anxiety

Anxiety disorders occur at an increased rate in children with asthma; however, there is only a small evidence base to support specific psychological treatments for these children. The current study evaluated the efficacy of a pilot cognitive behavioural treatment (CBT) group intervention for children with asthma and a comorbid anxiety disorder in a case series design. Five children (aged 8–11 years old) with asthma and a comorbid anxiety disorder and their mothers took part in eight 1-hour group treatment sessions. Primary outcomes measures were anxiety diagnosis and asthma-related quality of life. Secondary outcome measures were asthma symptom control and parent quality of life associated with caring for a child with asthma. Three of the participants no longer met diagnostic criteria for an anxiety disorder following treatment and three different participants reported a reliable improvement in asthma-related quality of life. Two participants reported a reliable improvement in asthma symptom control. Three mothers reported an improvement in caregiver quality of life. The findings provide preliminary proof of concept evidence for the efficacy of a CBT intervention for children with asthma and clinical anxiety.

Post-traumatic growth, distress and attachment style among women with breast cancer

ABSTRACTIdentifying factors fostering post-traumatic growth (PTG) is very important to promote PTG itself through specific psychological interventions. To this end, we investigated PTG and its relationship with clinical and psychological variables in a sample of 108 female breast cancer survivors. Results showed that women with higher depressive symptoms presented lower levels of PTG than women without. Moreover, women who had undergone combined treatment presented higher levels of PTG than women who had not. The results highlighted the resulting importance of psychological intervention focusing on depressive symptoms, which negatively interfere with the patients’ psychological growth.

A Psicologia no hospital geral: aspectos históricos, conceituais e práticos

Resumo A atuação da Psicologia aplicada ao ambiente hospitalar é marcada por fatos históricos relevantes que contribuíram para a definição da área e delimitação da prática profissional. Este artigo objetivou apresentar os aspectos históricos, conceituais e práticos da Psicologia no hospital geral nos Estados Unidos da América e no Brasil. Esse tipo de atividade da Psicologia se iniciou na década de 1950 e, posteriormente, ocorreu o reconhecimento da especialidade Psicologia da Saúde. A prática ocorre por meio da avaliação e intervenção psicológica hospitalar com especificidades, dependendo da abordagem teórica utilizada. No que se refere aos aspectos conceituais, o acompanhamento psicológico hospitalar visa facilitar a adaptação e enfrentamento das situações vivenciadas pelo paciente hospitalizado, assim como prioriza a tríade: paciente, família e equipe de saúde.

Improving Accident Statistics and Expanding the Role of Traffic Psychologists in Brazil

Abstract Due to the mandatory assessment of psychological fitness to drive of prospective drivers, Brazil has a relatively large amount of traffic psychologists. Since, in general, assessment only happens upon first licensing, the task of these psychologists is fairly limited (as is the scope of the assessment itself). Intention and method: this study aims to perform a critical analysis of possibilities to expand the role of psychologists working in the traffic system in Brazil. A systematic review study of databases and international documents was conducted and a scope of activity of psychologists in this area was built. First result statistical data is scattered over many agencies. First conclusion in order to better identify specific tendencies and risk groups in Brazil, statistical data related to accident involvement needs to be better, perhaps centrally, coordinated and consolidated. Second result international research related to three subgroups of drivers that constitute a significantly increased safety risk can inform future directions for traffic psychology in Brazil. Psychological processes that may underlie these risk increases are discussed. Second conclusion two subgroups (young drivers and aggressive drivers) could benefit from more than assessment, they could benefit from specific psychological interventions. The third subgroup (elderly drivers) is expected to increase significantly in the future, which asks for clearer policies, with a significant input form psychologists and psychological research.

Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes

While treatment of patients with attention-deficit hyperactivity disorder (ADHD) is based on a multimodal approach that combines medication with specific psychological interventions, pharmacotherapy alone is generally considered an essential and cost-effective element. This paper aims to comprehensively and critically review factors involved in prescribing and medication use in individuals diagnosed with ADHD, focusing on the difficulties facing patients with ADHD seeking treatment, as well as the safety and tolerability aspects of ADHD pharmacotherapies, with particular attention on the cardiovascular adverse events and the potential risk of misuse or diversion of ADHD medications. A comprehensive and systematic literature search of PubMed/MEDLINE database was conducted to identify studies published in peer-reviewed journals until 1 August 2016. Children, adolescents and adults often encounter significant difficulties in the process of accessing specialist assessment and treatment for ADHD as a consequence of disparities in service organization and available treatment provision. Despite the well-established efficacy and overall safety profile, ADHD medications are not exempt from adverse events. The cardiovascular safety of pharmacotherapies used for treating individuals with ADHD has raised particular concerns; however there is little evidence of serious cardiovascular adverse events, including no serious corrected QT (QTc) abnormalities associated with stimulants, atomoxetine or α2-adrenergic receptor agonists. Although the abuse of prescription stimulant drugs, particularly, short-acting stimulants is a prevalent and growing problem, nonmedical use of prescription stimulants within the clinical context is very limited. In addition, nonstimulant ADHD medications lack any reinforcing effects and consequently any abuse potential.

Psychiatric Disorders in Puerperium

Introduction: Post partum psychiatric illness was initially conceptualized as a group of disorders specifically linked to pregnancy and childbirth and thus was considered diagnostically distinct from other types. More recent evidence suggest that Post partum psychiatric disorder is virtually indistinguishable from psychiatric disorders that occur at other times during a woman’s life. A wide variety of disorders are seen. Recognition of disorders for the mother-infant relationship is important, because these have pernicious long-term effects but generally respond to treatment.Objective: The objective of this review is to highlight the different type of psychiatric disorders in the puerperium and their management.Materials and Methods: Literature of reputed journals were used to prepare this article with the help of pshychiatric consultant.Results: Psychiatric disorder in puperium has got different severity. Commonly encountered disorders are: Maternity blues, Post natal depression, Post partum psychosis. Most common is related to manic depression, in which neuroleptic drugs should be used with caution. Eighty five (85%) of women experiences mood changes in postpartum. About 10%-15% of women develops post partum depression. 0.1% -0.2% experience postpartum psychosis. 4,00000 children are born to depressed mothers every year.Conclusion: The obstetrics team should alert both to possible interaction between psychological and obstretics factors and to the range of psychiatric disorders that may occur during pregnancy and puperium. The obstetrics and psychiatric teams should work together to improve their services locally and high light the need for greater service provision every where ic stress disorder, obsessions of child harm, and a range of anxiety disorders all require specific psychological treatments. Postpartum depression necessitates thorough exploration. Cessation of breastfeeding is not necessary, because most antidepressant drugs seem not to affect the infant. Controlled trials have shown the benefit of involving the child’s father in therapy and of interventions promoting interaction between mother and infant. Owing to its complexity, multidisciplinary specialist teams have an important place in postpartum period. It should have clinical priority those are suffering from psychiatric problem during puperium as they are in crucial situation. It is important to recognize earliar to avoid undesirable consequences, which are harmful both for mother and infant.. According to severity patient may need counseling, social support, sometimes patient may need hospitalization in severe cases. There are several traditional methods worldwide sometimes they are beneficial and sometimes harmful to mother and infant.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 38-43

Health-Related Quality of Life in HIV-Infected Men Who Have Sex with Men in China: A Cross-Sectional Study

BackgroundChina is undergoing a rapid growth in the human immunodeficiency virus (HIV) epidemic involving men who have sex with men (MSM). Reports about their health-related quality of life (HRQOL) are scarce. This study aimed to assess the HRQOL and factors influencing HIV-positive MSM in a city in the northeast of China.Material/MethodsA cross-sectional study was conducted in Harbin city (Heilongjiang, China). HIV-positive MSM (n=125) were interviewed using the WHOQOL-HIV-BRIEF scale, the Berger HIV Stigma Scale, and other HIV-related questionnaires from June to August 2013.ResultsAmong the 6 dimensions of the HRQOL, HIV-related stigma was negatively associated with psychological (r=−0.316, P=0.0003) and spirituality domains (r=−0.324, P=0.0002). Physician support was positively associated with independence domain (r=0.393, P<0.0001). Hostile mentality was associated with psychological (r=0.479, P<0.0001) and spirituality domains (r=0.431, P<0.0001). Adverse effects of HAART were significantly correlated with physical (r=−0.542, P<0.0001) and psychological (r=−0.554, P<0.0001) domains. Multiple logistic regression showed that stigma (odds ratio (OR)=1.251, 95% confidence interval (95%CI): 1.088–1.439, P=0.002) and adverse effects of HAART (OR=1.117, 95%CI: 1.069–1.167, P<0.0001) were independent risk factors for low HRQOL. Physician support (OR=0.961, 95%CI: 0.941–0.982, P=0.0002) and CD4+ counts >350 (OR=0.033, 95%CI: 0.005–0.208, P=0.001) were independent protective factors in MSM receiving HAART. Hostile mentality (OR=0.936, 95%CI: 0.906–0.967, P<0.0001) was an independent protective factor of HRQOL in MSM not receiving HAART.ConclusionsPsychological factors such as HIV-related stigma, hostile mentality, and physician support have a significant effect on HRQOL in MSM. These findings suggest specific psychological interventions to improve HRQOL in HIV-positive MSM in China.