Background
Method
HIV-infected patients with mental health problems
Control subjects: the general HIV-population of Amsterdam
Control subjects: homosexual men with a lifetime dysthymic or depressive disorder
Measures
Analyses
Results
Cohort of patients from the outpatient clinic for HIV and Mental Health (N = 196)
Amsterdam-Clinic | Amsterdam-ATHENA | ||||
---|---|---|---|---|---|
N or mean
|
Valid% or range *
|
N or mean
|
Valid% or range
|
p value
| |
Age at intake
| 42 (± 8.8) | (18–65) | 43.8 (± 10.6) | (1–81.9) | p = 0.03 |
Age at HIV diagnosis
| 35 (± 8.8) | (15–64) | 35.5 (± 10.2) | (0–81.5) | p = 0.6 |
Male
| 172 | 87.7% | 4380 | 79.6% | p = 0.06 |
Homosexual men
| 148 | 77.5% | 3437 | 64.8% | p = 0.002 |
Has a partner
| 91 | 48.9% | |||
Has a paid day job
(>12 hr/week)
| 112 | 60.2% | |||
Has a psychiatric history
| 128 | 68.4% | |||
Has a Dutch origin
| 143 | 74.1% | 2886 | 54.4% | p < 0.0001 |
Drug used past 30 days
| 75 | 43.4% | |||
Cannabis
| 45 | 26.3% | |||
Ecstasy, speed, cocaine
| 46 | 26.9% | |||
Heroin, LSD
| 2 | 1.2% | |||
Education
| |||||
Basic
| 13 | 7.2% | |||
Intermediate
| 94 | 52.2% | |||
High
| 73 | 40.6% | |||
Years of HIV
| 7.0 (± 6.3) | (0–25) | 8.3 (± 6.0) | (0–26.5) | p < 0.001 |
0 – 1
| 30 | 15.8% | 436 | 8.3% | p < 0.001 |
1 – 5
| 65 | 34.2% | 1458 | 27.9% | |
5 – 10
| 43 | 22.6% | 1432 | 27.3% | |
> 10
| 52 | 27.4% | 1910 | 36.5% | |
CD4 cells/mm3
| 488 (± 234.7) | (20–1300) | 522 (± 258) | (0–2150) | p = 0.1 |
0 – 200
| 11 | 7.0% | 332 | 7.5% | p = 0.004 |
201 – 500
| 93 | 58.9% | 2014 | 45.7% | |
> 500
| 54 | 34.2% | 2060 | 46.8% | |
Is on antiviral treatment
| 132 | 68.8% | 4119 | 77.7% | p = 0.004 |
Comparison with the general HIV-infected population in Amsterdam
N | % | ||
---|---|---|---|
Depression
| |||
MDD without dysthymic disorder
| 51 | 26.0% | |
Dysthymic disorder without MDD
| 34 | 17.3% | |
MDD and dysthymic disorder
| 18 | 9.2% | |
MDD or dysthymic disorder with comorbid anxiety disorder
| 29 | 14.8% | |
Anxiety disorder
| 42 | 21.4% | |
Substance use (dependence or abuse)
| |||
Alcohol without drugs
| 11 | 5.6% | |
Drugs without alcohol
| 20 | 10.2% | |
Alcohol and drugs
| 4 | 2.0% | |
Bipolar disorder II, hypomanic or psychotic disorder
| 9 | 4.6% | |
Adjustment disorders
| 19 | 9.7% | |
Other problems (V-codes)
| 61 | 31.1% | |
Relational problems
| 16 | 8.2% | |
Additional problems (such as bereavement, phase of life problem, identity problem, occupational problem)
| 41 | 20.9% |
Effect of the duration of the HIV-infection
0 – 1 yr
|
1 – 5 yr
|
5 – 10 yr
|
> 10 yr
|
p-values
|
p-values
| |
---|---|---|---|---|---|---|
(n = 30)
|
(n = 65)
|
(n = 43)
|
(n = 52)
|
(overall)
|
(0 vs.10 yrs)
| |
Age
| 41.0 (± 10.9) | 38.9 (± 8.4) | 41.6 (± 7.8) | 47.1 (± 6.5) | 0.000
1
| 0.002
1
|
Male
| 93.3% | 86.2% | 86.0% | 86.5% | 0.723
3
| 0.327
3
|
Homosexual men
| 83.3% | 83.1% | 81.4% | 76.0% | 0.778
2
| 0.438
2
|
Dutch origin
| 66.7% | 70.8% | 74.4% | 84.6% | 0.234
2
| 0.059
2
|
Has a partner
| 48.1% | 44.4% | 44.2% | 60.0% | 0.341
2
| 0.318
2
|
Paid job (>12 hr/week)
| 76.9% | 69.2% | 58.1% | 40.8% | 0.005
2
| 0.003
2
|
Psychiatric history
| 59.3% | 63.1% | 64.3% | 84.0% | 0.049
2
| 0.016
2
|
CD4 cells/mm3
| 358 (± 139.8) | 470 (± 185.0) | 601 (± 254.6) | 493 (± 279.3) | 0.001
1
| 0.026
1
|
IDS (depressive symptoms)
| 28.5 (± 13.28) | 29.1 (± 12.33) | 33.2 (± 15.08) | 28.9 (± 12.50) | 0.341
1
| 0.910
1
|
BAI (anxiety symptoms)
| 19.1 (± 12.66) | 16.5 (± 10.62) | 20.1 (± 12.45) | 14.9 (± 10.98) | 0.119
1
| 0.117
1
|
4DSQ (somatization)
| 44.8% | 48.4% | 47.6% | 44.2% | 0.969
2
| 0.959
2
|
Drug used past 30 days
| 32.0% | 51.7% | 12.5% | 38.7% | 0.276
2
| 0.581
2
|
Suicide ideation
| 37.9% | 51.6% | 50.0% | 48.0% | 0.762
2
| 0.385
2
|
Suicide attempt (life-time)
| 17.9% | 29.5% | 21.6% | 34.0% | 0.377
2
| 0.131
2
|
Comparison with HIV-negative depressive homosexual men
HIV-infected
|
Non HIV-infected
|
p-values
|
p-values
| |
---|---|---|---|---|
(N = 84)
|
(N = 60)
|
(not adjusted)
|
(adjusted *)
| |
Age
| 42.2 (± 8.4) | 44.3 (± 11.6) | 0.204
1
| 0.706 |
Dutch origin
| 76.2% | 93.3% | 0.005
2
| 0.214 |
Has a partner
| 60.5% | 51.7% | 0.191
2
| 0.965 |
Paid job (>12 hr/week)
| 57.1% | 61.7% | 0.524
2
| 0.843 |
High educational level
| 54.5% | 51.7% | 0.738
2
| 0.240 |
(adjusted**)
| ||||
IDS (depressive symptoms)
| 33.6 (± 12.79) | 25.9 (± 13.38) | 0.000
1
| 0.357
3
|
BAI (anxiety symptoms)
| 19.3 (± 12.26) | 13.4 (± 10.65) | 0.002
1
| 0.440
3
|
Fear Q
| 28.6 (± 19.94) | 27.5 (±19.37) | 0.761
1
| 0.210
3
|
Suicide ideation
| 53.6% | 20.0% | 0.000
2
| 0.009
4
|
Suicide attempt (life-time)
| 28.6% | 30.0% | 0.852
2
| 0.967
4
|
IRS (sleep)
| 10.6 (± 5.52) | 9.45 (± 5.04) | 0.224
1
| 0.386
3
|
MASQ: positive affect
| 39.6 (± 7.93) | 37.6 (± 8.09) | 0.161
1
| 0.248
3
|
MASQ: negative affect
| 28.8 (± 8.71) | 23.0 (± 7.61) | 0.000
1
| 0.065
3
|
MASQ: somatic arousal
| 18.9 (± 7.20) | 16.6 (± 6.26) | 0.065
1
| 0.627
3
|
4DSQ score
| 15.2 (± 10.76) | 12.9 (± 10.00) | 0.194
1
| 0.882
3
|
4DSQ: somatization
| 56.6% | 50.0% | 0.433
2
| 0.831
4
|
AUDIT score (alcohol use)
| 6.36 (± 5.69) | 6.33 (± 5.59) | 0.977
1
| 0.190
3
|
If drinker: glasses per month
| 29.9 (± 36.62) | 22.9 (± 31.33) | 0.279
1
| 0.241
3
|
If drinker: glasses per session
| 2.90 (± 1.77) | 1.76 (± 1.91) | 0.001
1
| 0.003
3
|
Drugs used past 30 days
| 54.3% | 21.7% | 0.000
2
| 0.006
4
|
Cannabis
| 33.3% | 15.0% | 0.016
2
| 0.107
4
|
Ecstasy, speed, cocaine
| 30.4% | 10.0% | 0.004
2
| 0.059
4
|
Heroin, LSD
| 1.4% | 1.7% | 0.921
2
| 0.998
4
|
NEO: neuroticism
| 42.8 (± 6.84) | 39.0 (± 7.81) | 0.002
1
| 0.055
3
|
NEO: extraversion
| 33.0 (± 7.16) | 33.7 (± 7.18) | 0.592
1
| 0.866
3
|
NEO: openness
| 32.7 (± 5.28) | 39.6 (± 5.68) | 0.000
1
| 0.000
3
|
NEO: agreeableness
| 40.5 (± 5.86) | 42.0 (± 6.23) | 0.162
1
| 0.587
3
|
NEO: conscientiousness
| 34.5 (± 6.77) | 40.1 (± 6.94) | 0.000
1
| 0.001
3
|