SOMATIC SYMPTOMS AND HIV-INFECTION - RELATIONSHIP TO DEPRESSIVE SYMPTOMS AND INDICATORS OF HIV DISEASE

Objective: This study examined the relationship of the somatic symptom s fatigue and insomnia with indicators of both psychiatric disturbance and HIV disease severity. Method: Study participants were 98 asymptom atic HIV-infected and 71 uninfected homosexual men; 82 HIV-infected an d 64 uninfected men had 6-month follow-tip examinations. Scales from t he self-reported Profile of Mood States measured fatigue and dysphoric mood. Major depression diagnosis was determined by the Structured Cli nical Interview for DSM-III-R. Selected items from the Hamilton depres sion and anxiety scales measured insomnia and other symptoms of depres sion. Performance on a battery of standardized tests determined neurop sychological function ratings. Results: At study entry, complaints of fatigue and insomnia were associated with dysphoric mood, major depres sion, and other non-HIV-related symptoms of major depression but not w ith CD4 cell counts or neuropsychological functioning Increases in lev els of fatigue and insomnia over the 6-month follow-up period were ass ociated with increases in non-HIV-related symptoms of depression and i n severity of dysphoric mood. Increases in fatigue were also associate d with decrements in motor functioning. Otherwise, fatigue or insomnia were not associated with HIV disease progression. Conclusions: These findings suggest that complaints of fatigue and insomnia in otherwise asymptomatic HIV-infected patients are likely to be related to psychol ogical disturbances and possibly major depression, which can be treate d. HIV-infected patients who complain of fatigue or insomnia should ro utinely be assessed for major depression.