Skip to main content
Erschienen in: Community Mental Health Journal 6/2011

01.12.2011 | Original Paper

Using Psychiatric Symptomatology to Assess Risk for HIV Infection in Individuals with Severe Mental Illness

verfasst von: Evan S. Wu, Aileen Rothbard, Michael B. Blank

Erschienen in: Community Mental Health Journal | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

In this study, we use the Colorado Symptom Index, a measure of psychiatric symptomatology, to identify vulnerable subgroups within the severely mentally ill population at elevated risk for HIV infection. Baseline data on 228 HIV positive and 281 HIV negative participants from two clinical trials were used. With years to HIV diagnosis as our primary endpoint, Kaplan–Meier estimates were calculated to find a CSI cut-off score, and a Cox proportional hazards model was used to obtain relative risks of infection for the two CSI categories created by the cut point. We found that a CSI score ≥ 30 was associated with a 47% increased risk for HIV infection (P < 0.01). While this study establishes the foundation for using CSI scores to identify a vulnerable subgroup within the SMI community, further studies should develop effective approaches to mitigate psychiatric symptomatology in order to examine the impact on HIV transmission risky behaviors.
Literatur
Zurück zum Zitat Blank, M. B., Mandell, D. S., Aiken, L., & Hadley, T. R. (2002). Co-occurrence of HIV and serious mental illness among medicaid recipients. Psychiatric Services (Washington, D.C.), 53(7), 868–873. Blank, M. B., Mandell, D. S., Aiken, L., & Hadley, T. R. (2002). Co-occurrence of HIV and serious mental illness among medicaid recipients. Psychiatric Services (Washington, D.C.), 53(7), 868–873.
Zurück zum Zitat Blank, M. B., Metzger, D. S., Wingood, G. M., & DiClemente, R. J. (2008). The first national scientific meeting of the social and behavioral science research network. Journal of Acquired Immune Deficiency Syndromes (1999), 47(1), S1-4. Blank, M. B., Metzger, D. S., Wingood, G. M., & DiClemente, R. J. (2008). The first national scientific meeting of the social and behavioral science research network. Journal of Acquired Immune Deficiency Syndromes (1999), 47(1), S1-4.
Zurück zum Zitat Boothroyd, R. A., & Chen, H. J. (2008). The psychometric properties of the colorado symptom index. Administration and Policy In Mental Health, 35(5), 370–378.PubMedCrossRef Boothroyd, R. A., & Chen, H. J. (2008). The psychometric properties of the colorado symptom index. Administration and Policy In Mental Health, 35(5), 370–378.PubMedCrossRef
Zurück zum Zitat Brooner, R. K., Greenfield, L., Schmidt, C. W., & Bigelow, G. E. (1993). Antisocial personality disorder and HIV infection among intravenous drug abusers. The American Journal of Psychiatry, 150(1), 53–58.PubMed Brooner, R. K., Greenfield, L., Schmidt, C. W., & Bigelow, G. E. (1993). Antisocial personality disorder and HIV infection among intravenous drug abusers. The American Journal of Psychiatry, 150(1), 53–58.PubMed
Zurück zum Zitat Brunette, M. F., Mercer, C. C., Carlson, C. L., Rosenberg, S. D., & Lewis, B. F. (2000). HIV-related services for persons with severe mental illness: Policy and practice in new hampshire community mental health. The Journal of Behavioral Health Services & Research, 27(3), 347–353.CrossRef Brunette, M. F., Mercer, C. C., Carlson, C. L., Rosenberg, S. D., & Lewis, B. F. (2000). HIV-related services for persons with severe mental illness: Policy and practice in new hampshire community mental health. The Journal of Behavioral Health Services & Research, 27(3), 347–353.CrossRef
Zurück zum Zitat Carey, M. P., Carey, K. B., Maisto, S. A., Schroder, K. E., Vanable, P. A., & Gordon, C. M. (2004). HIV risk behavior among psychiatric outpatients: Association with psychiatric disorder, substance use disorder, and gender. The Journal of Nervous and Mental Disease, 192(4), 289–296.PubMedCrossRef Carey, M. P., Carey, K. B., Maisto, S. A., Schroder, K. E., Vanable, P. A., & Gordon, C. M. (2004). HIV risk behavior among psychiatric outpatients: Association with psychiatric disorder, substance use disorder, and gender. The Journal of Nervous and Mental Disease, 192(4), 289–296.PubMedCrossRef
Zurück zum Zitat Carey, M. P., Weinhardt, L. S., & Carey, K. B. (1995). Prevalence of infection with HIV among the seriously mentally ill: Review of the research and implications for practice. Professional Psychology: Research and Practice., 26, 262–268.CrossRef Carey, M. P., Weinhardt, L. S., & Carey, K. B. (1995). Prevalence of infection with HIV among the seriously mentally ill: Review of the research and implications for practice. Professional Psychology: Research and Practice., 26, 262–268.CrossRef
Zurück zum Zitat Ciarlo, J., & Edwards, D. (1981). The assessment of client/patient outcome: techniques for use in mental health programs. Washington: National Institute of Mental Health. Ciarlo, J., & Edwards, D. (1981). The assessment of client/patient outcome: techniques for use in mental health programs. Washington: National Institute of Mental Health.
Zurück zum Zitat Conrad, K. J., Yagelka, J. R., Matters, M. D., Rich, A. R., Williams, V., & Buchanan, M. (2001). Reliability and validity of a modified colorado symptom index in a national homeless sample. Mental Health Services Research, 3(3), 141–153.PubMedCrossRef Conrad, K. J., Yagelka, J. R., Matters, M. D., Rich, A. R., Williams, V., & Buchanan, M. (2001). Reliability and validity of a modified colorado symptom index in a national homeless sample. Mental Health Services Research, 3(3), 141–153.PubMedCrossRef
Zurück zum Zitat Cournos, F., & McKinnon, K. (1997). HIV seroprevalence among people with severe mental illness in the United States: A critical review. Clinical Psychology Review, 17(3), 259–269.PubMedCrossRef Cournos, F., & McKinnon, K. (1997). HIV seroprevalence among people with severe mental illness in the United States: A critical review. Clinical Psychology Review, 17(3), 259–269.PubMedCrossRef
Zurück zum Zitat Coverdale, J. H., & Turbott, S. H. (2000). Sexual and physical abuse of chronically ill psychiatric outpatients compared with a matched sample of medical outpatients. The Journal of Nervous and Mental Disease, 188(7), 440–445.PubMedCrossRef Coverdale, J. H., & Turbott, S. H. (2000). Sexual and physical abuse of chronically ill psychiatric outpatients compared with a matched sample of medical outpatients. The Journal of Nervous and Mental Disease, 188(7), 440–445.PubMedCrossRef
Zurück zum Zitat Dickey, B., Normand, S. L., Weiss, R. D., Drake, R. E., & Azeni, H. (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services (Washington, D.C.), 53(7), 861–867. Dickey, B., Normand, S. L., Weiss, R. D., Drake, R. E., & Azeni, H. (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services (Washington, D.C.), 53(7), 861–867.
Zurück zum Zitat Dixon, L., Postrado, L., Delahanty, J., Fischer, P. J., & Lehman, A. (1999). The association of medical comorbidity in schizophrenia with poor physical and mental health. The Journal of Nervous and Mental Disease, 187(8), 496–502.PubMedCrossRef Dixon, L., Postrado, L., Delahanty, J., Fischer, P. J., & Lehman, A. (1999). The association of medical comorbidity in schizophrenia with poor physical and mental health. The Journal of Nervous and Mental Disease, 187(8), 496–502.PubMedCrossRef
Zurück zum Zitat Grassi, L. (1996). Risk of HIV infection in psychiatrically ill patients. AIDS Care, 8(1), 103–116.PubMedCrossRef Grassi, L. (1996). Risk of HIV infection in psychiatrically ill patients. AIDS Care, 8(1), 103–116.PubMedCrossRef
Zurück zum Zitat Green, R. S., & Gracely, E. J. (1987). Selecting a rating scale for evaluating services to the chronically mentally ill. Community Mental Health Journal, 23(2), 91–102.PubMedCrossRef Green, R. S., & Gracely, E. J. (1987). Selecting a rating scale for evaluating services to the chronically mentally ill. Community Mental Health Journal, 23(2), 91–102.PubMedCrossRef
Zurück zum Zitat Himelhoch, S., Josephs, J. S., Chander, G., Korthuis, P. T., Gebo, K. A., & HIV Research Network. (2009). Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study. General Hospital Psychiatry, 31(6), 538–545.PubMedCrossRef Himelhoch, S., Josephs, J. S., Chander, G., Korthuis, P. T., Gebo, K. A., & HIV Research Network. (2009). Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study. General Hospital Psychiatry, 31(6), 538–545.PubMedCrossRef
Zurück zum Zitat Kalichman, S. C., Kelly, J. A., Johnson, J. R., & Bulto, M. (1994). Factors associated with risk for HIV infection among chronic mentally ill adults. The American Journal of Psychiatry, 151(2), 221–227.PubMed Kalichman, S. C., Kelly, J. A., Johnson, J. R., & Bulto, M. (1994). Factors associated with risk for HIV infection among chronic mentally ill adults. The American Journal of Psychiatry, 151(2), 221–227.PubMed
Zurück zum Zitat Lawless, J. F., & Louis A. (Duhring Fund). (2003). Statistical models and methods for lifetime data (2nd ed.). Hoboken, N.J: Wiley-Interscience. Lawless, J. F., & Louis A. (Duhring Fund). (2003). Statistical models and methods for lifetime data (2nd ed.). Hoboken, N.J: Wiley-Interscience.
Zurück zum Zitat McKinnon, K., & Cournos, F. (1998). HIV infection linked to substance use among hospitalized patients with severe mental illness. Psychiatric Services (Washington, D.C.), 49(10), 1269. McKinnon, K., & Cournos, F. (1998). HIV infection linked to substance use among hospitalized patients with severe mental illness. Psychiatric Services (Washington, D.C.), 49(10), 1269.
Zurück zum Zitat McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the addiction severity index. Journal of Substance Abuse Treatment, 9(3), 199–213.PubMedCrossRef McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the addiction severity index. Journal of Substance Abuse Treatment, 9(3), 199–213.PubMedCrossRef
Zurück zum Zitat Metzger, D. S., Woody, G. E., McLellan, A. T., O’Brien, C. P., Druley, P., Navaline, H., et al. (1993). Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: An 18-month prospective follow-up. Journal of Acquired Immune Deficiency Syndromes, 6(9), 1049–1056.PubMed Metzger, D. S., Woody, G. E., McLellan, A. T., O’Brien, C. P., Druley, P., Navaline, H., et al. (1993). Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: An 18-month prospective follow-up. Journal of Acquired Immune Deficiency Syndromes, 6(9), 1049–1056.PubMed
Zurück zum Zitat Rosenberg, S. D., Trumbetta, S. L., Mueser, K. T., Goodman, L. A., Osher, F. C., Vidaver, R. M., et al. (2001). Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness. Comprehensive Psychiatry, 42(4), 263–271.PubMedCrossRef Rosenberg, S. D., Trumbetta, S. L., Mueser, K. T., Goodman, L. A., Osher, F. C., Vidaver, R. M., et al. (2001). Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness. Comprehensive Psychiatry, 42(4), 263–271.PubMedCrossRef
Zurück zum Zitat Rothbard, A. B., Lee, S., & Blank, M. B. (2009). Cost of treating seriously mentally ill persons with HIV following highly active retroviral therapy (HAART). The Journal of Mental Health Policy and Economics, 12(4), 187–194.PubMed Rothbard, A. B., Lee, S., & Blank, M. B. (2009). Cost of treating seriously mentally ill persons with HIV following highly active retroviral therapy (HAART). The Journal of Mental Health Policy and Economics, 12(4), 187–194.PubMed
Zurück zum Zitat Sikkema, K. J., Watt, M. H., Drabkin, A. S., Meade, C. S., Hansen, N. B., & Pence, B. W. (2010). Mental health treatment to reduce HIV transmission risk behavior: A positive prevention model. AIDS and Behavior, 14(2), 252–262.PubMedCrossRef Sikkema, K. J., Watt, M. H., Drabkin, A. S., Meade, C. S., Hansen, N. B., & Pence, B. W. (2010). Mental health treatment to reduce HIV transmission risk behavior: A positive prevention model. AIDS and Behavior, 14(2), 252–262.PubMedCrossRef
Zurück zum Zitat Walkup, J., Blank, M. B., Gonzalez, J. S., Safren, S., Schwartz, R., Brown, L., et al. (2008). The impact of mental health and substance abuse factors on HIV prevention and treatment. Journal of Acquired Immune Deficiency Syndromes (1999), 47 (1), S15–S19. Walkup, J., Blank, M. B., Gonzalez, J. S., Safren, S., Schwartz, R., Brown, L., et al. (2008). The impact of mental health and substance abuse factors on HIV prevention and treatment. Journal of Acquired Immune Deficiency Syndromes (1999), 47 (1), S15–S19.
Zurück zum Zitat Woody, G. E., Metzger, D., Navaline, H., McLellan, T., & O’Brien, C. P. (1997). Psychiatric symptoms, risky behavior, and HIV infection. NIDA Research Monograph, 172, 156–170.PubMed Woody, G. E., Metzger, D., Navaline, H., McLellan, T., & O’Brien, C. P. (1997). Psychiatric symptoms, risky behavior, and HIV infection. NIDA Research Monograph, 172, 156–170.PubMed
Metadaten
Titel
Using Psychiatric Symptomatology to Assess Risk for HIV Infection in Individuals with Severe Mental Illness
verfasst von
Evan S. Wu
Aileen Rothbard
Michael B. Blank
Publikationsdatum
01.12.2011
Verlag
Springer US
Erschienen in
Community Mental Health Journal / Ausgabe 6/2011
Print ISSN: 0010-3853
Elektronische ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-011-9402-0

Weitere Artikel der Ausgabe 6/2011

Community Mental Health Journal 6/2011 Zur Ausgabe

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Typ-2-Diabetes und Depression folgen oft aufeinander

14.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes sind überdurchschnittlich gefährdet, in den nächsten Jahren auch noch eine Depression zu entwickeln – und umgekehrt. Besonders ausgeprägt ist die Wechselbeziehung laut GKV-Daten bei jüngeren Erwachsenen.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Spezielles Sportprogramm bei einer Reihe von psychischen Erkrankungen effektiv

08.05.2024 Psychotherapie Nachrichten

Sportliche Betätigung hilft nicht nur bei Depression, sondern auch in Gruppen von Patientinnen und Patienten mit unterschiedlichen psychischen Erkrankungen, wie Insomnie, Panikattacken, Agoraphobie und posttraumatischem Belastungssyndrom. Sie alle profitieren längerfristig.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.