PERSONALITY-DISORDERS PREDICT ONSET OF AXIS-I DISORDERS AND IMPAIRED FUNCTIONING AMONG HOMOSEXUAL MEN WITH AND AT RISK OF HIV-INFECTION

Background: A longitudinal study was conducted to investigate whether personality disorders (PDs) increase risk for the development of futur e Axis I disorders and serious functional impairment among human immun odeficiency virus (HIV)-seropositive and HIV-seronegative homosexual m en. Method: Baseline assessments of PDs, Axis I disorders and symptoms , and Global Assessments of Functioning were conducted with a communit y sample of 107 (66 HIV-positive and 41 HIV-negative) homosexual men p articipating in a longitudinal study with semiannual interviews over 3 years. Results: Logistic regression analysis indicated that PDs predi cted onset of subsequent Axis I disorders after controlling for both H IV status and lifetime Axis I history (adjusted odds ratio, 4.31; P=.0 1; 95% confidence interval, 1.39 to 13.32). Of the 21 participants wit h PDs, 16 (76%) were subsequently diagnosed with Axis I disorders on a t least one occasion. By contrast, only 36 (42%) of the 86 participant s without PDs were subsequently diagnosed with Axis I disorders. Furth er, 33% of the participants with PDs, in comparison with only 8% of th ose without PDs, were assigned Global Assessments of Functioning score s of 50 or lower, indicating serious impairment during the postbaselin e study period (adjusted odds ratio, 5.70; P<.005; 95% confidence inte rval, 1.66 to 19.53). Conclusion: Personality disorders may contribute to increased risk for onset of Axis I disorders and serious impairmen t among homosexual men regardless of HIV serologic status.