PSYCHOPATHOLOGY IN 90 CONSECUTIVE HUMAN IMMUNODEFICIENCY VIRUS-SEROPOSITIVE AND ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME PATIENTS WITH MOSTLY INTRAVENOUS DRUG-USE HISTORY

This report presents systematic clinical data regarding psychiatric di agnoses, personal and family psychiatric histories, and symptomatologi c aspects of 90 consecutive human immunodeficiency virus (HIV)-seropos itive and acquired immune deficiency syndrome (AIDS) patients, of whom slightly less than two thirds were at risk due to intravenous drug ab use. In addition, a comparison was made between the distribution patte rns of these variables at various stages of HIV illness and related at -risk behaviors. Eighty-four percent of the patients met criteria for a spectrum of DSM-III-R diagnoses (mostly affective) that were associa ted with high rates of affective and alcohol abuse disorders among fir st-degree relatives. Mood disorders did not differ significantly betwe en the two main groups at risk (intravenous drug users [IVDUs] v other s) by gender, age, or stage of illness. The overall data from the rati ng scales show high levels of psychic and somatic anxiety in the early stages of illness, whereas cognitive symptoms, retardation, and disor ientation are dominant in later stages. A noteworthy finding in this s tudy is that many depressed patients demonstrated current and/or past hypomanic, hyperthymic, or cyclothymic features with no evidence of br ain damage detectable by computed axial tomography (CAT). These temper amental attributes, which preceded HIV infection, may have served as r isk factors for both drug abuse and impulsive sexual behavior in all t ypes of at-risk groups. Copyright (C) 1996 by W.B. Saunders Company