Psychiatric co-morbidity in South African HIV/AIDS patients

Background. To the best of our knowledge no previous studies have been publ ished on the rates of psychopathology in HIV-infected patients from a predo minantly black, heterosexual Third-World population. Objective. To evaluate the levels of anxiety experienced by patients infect ed with HIV the presence of specific anxiety and other psychiatric disorder s, as well as to determine whether this is associated with disease stage an d time after diagnosis. Methods. One hundred HIV-infected patients attending the immunology clinics at the Universitas and Pelonomi hospitals in Bloemfontein, South Africa, w ere screened for the presence of psychiatric disorders using the Mini Inter national Neuropsychiatric Interview (MINI). More specifically, anxiety was evaluated using the Zung self-rating and Hamilton anxiety (HAM-A) scales. D isease stage of the patient was determined by clinical examination and CD4* T-cell count values. Results. According to the MINI, 35% of the patients had a major depressive disorder. A further 3% had dysthymic disorder, while bipolar disorder was d iagnosed in 6%. As regards anxiety disorders, the following was found: pani c disorder 37%, agoraphobia 9%, social phobia 15%, specific phobias 10%, ob sessive-compulsive disorder 3% and generalised anxiety disorder 21%. Post-t raumatic stress disorder was diagnosed in 6%. Thirty-one of the patients sc ored above the cut-off on both the HAM-A and Zung scales. Conclusions. The results indicate that psychiatric comorbidity is common in HIV-infected patients. Anxiety and depressive disorders were found in a la rge number of patients, significantly more than the proportion expected in the general population. The identification and treatment of these co-morbid psychiatric syndromes in HIV-infected patients should he actively pursued, as treatment could lead to an improvement in quality of life.