STABILITY OF MOOD DESPITE HIV ILLNESS PROGRESSION IN A GROUP OF HOMOSEXUAL MEN

Objective: The authors investigated the association between mood statu s and progression of HIV illness. Method: In a research clinic at a un iversity medical center, 112 HIV-positive and 52 HIV-negative homosexu al men were enrolled in a 4-year prospective study with semiannual ass essments. The main study measures were psychiatric diagnoses according to the Structured Clinical Interview for DSM-III-R; level of function ing and psychiatric symptoms according to the Global Assessment of Fun ctioning Scale (axis V, DSM-III-R), the Hamilton depression and anxiet y scales, the Brief Symptom Inventory, and the Beck Hopelessness Scale ; stage of HIV illness; and CD4 cell count. Results: Among the HIV-pos itive men, there was no increase in rates of syndromal depression and anxiety over the 4 years despite substantial HIV illness progression. On all occasions, mean psychopathology symptom ratings were within the normal or not depressed range. However, compared to the HIV-negative men, the HIV-positive men had slightly more anxiety and somatic depres sive symptoms throughout. The only measure that showed an increase in distress over time was orientation to the future; among the HIV-positi ve men, hopes for the future waned across assessments. Attrition in th e group was largely attributable to the loss of men with lower CD4 cel l counts and more advanced HIV illness. However, study dropouts did no t differ on any psychiatric measure from subjects who remained during the first 3 years. Conclusions: In this group no significant increase in syndromal or symptomatic depression or anxiety over nine semiannual assessments was found, despite substantial HIV illness progression an d some deaths. Psychopathology did not predict dropout or death.