Impact of psychiatric conditions on health-related quality of life in persons with HIV infection

Objective: Little is known about the impact of comorbid psychiatric symptom s in persons with HIV. This study estimates the burden on health-related qu ality of life associated with comorbid psychiatric conditions in a national ly representative sample of persons with HIV. Method: The authors conducted a multistage sampling of urban and rural areas to produce a national proba bility sample of persons with HIV receiving medical care in the contiguous United States (N=2,864). Subjects were screened for psychiatric conditions with the short form of the Composite International Diagnostic interview. He avy drinking was assessed on the basis of quantity and frequency of drinkin g. Health-related quality of life was rated with a 28-item instrument adapt ed from similar measures used in the Medical Outcomes Study. Results: HIV s ubjects with a probable mood disorder diagnosis had significantly lower sco res on health-related quality of life measures than did those without such symptoms. Diminished health-related quality of life was not associated with heavy drinking, and in drug users it was accounted for by presence of a co moribid mood disorder. Conclusions: Optimization of health-related quality of life is particularly important now that HIV is a chronic disease with th e prospect of long-term survival. Comorbid psychiatric conditions may serve as markers for impaired functioning and well-being in persons with HIV, In clusion of sufficient numbers of appropriately trained mental health profes sionals to identify and treat such conditions may reduce unnecessary utiliz ation of other health services and improve health-related quality of life i n persons with HIV infection.