Abstract
Prevalence studies consistently show that most people with HIV illness do not have elevated rates of psychiatric disorder at any given time, but these studies do not permit characterization of overall levels of psychological distress in this population. This paper reviews published studies examining distress and depressive symptomatology in people with HIV/AIDS and matched comparison groups as assessed by self-report rating scales. Findings indicate that distress levels differ considerably across studies in comparison to population norms, although scores typically are not highly elevated for either seropositive or seronegative groups. Methodological issues that may explain variation across studies are discussed, including recruitment methods, composition of samples, and methods of assessing distress. It is suggested that psychological distress in those with HIV/AIDS should be examined with an understanding of the diversity of factors that can contribute to distress, as well as the differential availability of resources to cope with stressors among those infected.
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REFERENCES
Atkinson, J. H., Jr., Grant, I., Kennedy, C. J., Richman, D. D., Spector, S. A., and McCutchan, J. A. (1988). Prevalence of psychiatric disorders among men infected with human immunodeficiency virus: A controlled study. Archives of General Psychiatry, 45, 859-864.
Beck, A. T., and Beamsesderfer, A. (1974). Assessment of depression: The depression inventory. In P. Pichot (Ed.), Psychological measurements in psychopharmacology (pp. 151-160). Basel: S. Karger.
Beck, A. T., and Steer, R. A. (1988). Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.
Beck, A. T., Steer, R. A., and Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.
Blaney, N. T., Millon, C., Morgan, R., Eisdorfer, C., and Szapocznik, J. (1990). Emotional distress, stress related disruption and coping among healthy HIV positive gay males. Psychology and Health, 4, 259-273.
Bornstein, R. A., Pace, P., Rosenberger, P., Nasrallah, H. A., Para, M. F., Whitacre, C. C., and Fass, R. J. (1993). Depression and neuropsychological performance in asymptomatic HIV infection. American Journal of Psychiatry, 150, 922-927.
Catalan, J., Klimes, I., Day, A., Garrod, A., Bond, A., and Gallwey, J. (1992a). The psychosocial impact of HIV infection in gay men: A controlled investigation and factors associated with psychiatric morbidity. British Journal of Psychiatry, 161, 774-778.
Catalan, J., Klimes, I., Bond, A., Day, A., Garrod, A., and Rizza, C. (1992b). The psychosocial impact of HIV infection in men with haemophilia: Controlled investigation and factors associated with psychiatric morbidity. Journal of Psychosomatic Research, 36, 409-416.
Chuang, H. T., Jason, G. W., Pajurkova, E. M., and Gill, M. J. (1992). Psychiatric morbidity in patients with HIV infection. Canadian Journal of Psychiatry, 37, 109-115.
Cochran, S. D., and Mays, V. M. (1994). Depressive distress among homosexually active African American men and women. American Journal of Psychiatry, 151, 524-529.
Davis, R. F., Metzger, D. S., Meyers, K., McLellan, A. T., Mulvaney, F. D., Navaline, H. A., and Woody, G. E. (1995). Long term changes in psychological symptomatology associated with HIV serostatus among male injecting drug users. AIDS, 9, 73-79.
Derogatis, L. R. (1993a). SCL-90-R: Administration, scoring, and procedures manual, III. Minneapolis, MN: National Computer Systems.
Derogatis, L. R. (1993b). BSI: Administration, scoring, and procedures manual, III. Minneapolis, MN: National Computer Systems.
Dew, M. A., Ragni, M. V., and Nimorwicz, P. (1990). Infection with human immunodeficiency virus and vulnerability to psychiatric distress. A study of men with hemophilia. Archives of General Psychiatry, 47, 737-744.
Dilley, J. W., Ochitill, H. N., Perl, M., and Volberding, P. (1985). Findings in psychiatric consultations with patients with acquired immune deficiency syndrome. American Journal of Psychiatry, 142, 82-86.
Dorman, A., O'Connor, A., Hardiman, E., Freyne, A., and O'Neill, H. (1993). Psychiatric morbidity in sentenced segregated HIV positive prisoners. British Journal of Psychiatry, 163, 802-805.
Fell, M., Newman, S., Herns, M., Durrance, P., Manji, H., Connolly, S., McAllister, R., Weller, I., and Harrison, M. (1993). Mood and psychiatric disturbance in HIV and AIDS: Changes over time. British Journal of Psychiatry, 162, 604-610.
Franke, G. H., Jager, H., Thomann, B., and Beyer, B. (1992). Assessment and evaluation of psychological distress in HIV-infected women. Psychology and Health, 6, 297-312.
Gala, C., Pergami, A., Catalan, J., Durbano, F., Musicco, M., Riccio, M., Baldeweg, T., and Invernizzi, G. (1993). The psychosocial impact of HIV infection in gay men, drug users and heterosexuals. Controlled investigation. British Journal of Psychiatry, 163, 651-659.
Grant, I., Adams, K. M., Carlin, A. S., Rennick, P. M., Judd, L. L., and Schooff, K. (1978). The collaborative neuropsychological study of polydrug abusers. Archives of General Psychiatry, 35, 1063-1073.
Hays, R. B., Catania, J. A., McKusick, L., and Coates, T. J. (1990). Help-seeking for AIDS-related concerns: A comparison of gay men with various HIV diagnoses. American Journal of Community Psychology, 18, 743-755.
Herek, G. M., and Capitanio, J. P. (1993). Public reactions to AIDS in the United States: A second decade of stigma. American Journal of Public Health, 83, 574-577.
Hestad, K., Aukrust, P., Ellertsen, B., and Klove, H. (1994). Psychological difficulties related to human immunodeficiency virus-1 infection in intravenous drug users. Acta Psychiatrica Scandinavica, 90, 25-31.
Holland, J. C., and Tross, S. (1985). The psychosocial and neuropsychiatric sequelae of the acquired immunodeficiency syndrome and related disorders. Annals of Internal Medicine, 103, 760-764.
Hoover, D. R., Saah, A. J., Bacellar, H., Murphy, R., Visscher, B., Anderson, R., and Kaslow, R. A. (1993). Signs and symptoms of “asymptomatic” HIV-1 infection in homosexual men. Journal of Acquired Immune Deficiency Syndromes, 6, 66-71.
Jacobsen, P. B., Perry, S. W., and Hirsch, D. A. (1990). Behavioral and psychological responses to HIV antibody testing. Journal of Consulting and Clinical Psychology, 58, 31-37.
Joseph, J. G., Caumartin, S. M., Tal, M., Kirscht, J. P., Kessler, R. C., Ostrow, D. G., and Wortman, C. B. (1990). Psychological functioning in a cohort of gay men at risk for AIDS. A three year descriptive study. Journal of Nervous and Mental Disease, 178, 607-615.
Kalichman, S. C., Sikkema, K. J., and Somlai, A. (1995). Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: Disease processes and other potential confounds. Journal of Personality Assessment, 64, 86-100.
Krikorian, R., Kay, J., and Liang, W. M. (1995). Emotional distress, coping, and adjustment in human immunodeficiency virus infection and acquired immune deficiency syndrome. Journal of Nervous and Mental Disorders, 183, 293-298.
Kurdek, L., and Siesky, G. (1990). The nature and correlates of psychological adjustment in gay men with AIDS related conditions. Journal of Applied Social Psychology, 20, 846-860.
Leserman, J., DiSantostefano, R., Perkins, D. O., Murphy, C., Golden, R. N., and Evans, D. L. (1995). Longitudinal study of social support and social conflict as predictors of depression and dysphoria among HIV-positive and HIV-negative gay men. Depression, 2, 189-199.
Levin, B. E., Berger, J. R., Didona, T., and Duncan, R. (1992). Cognitive function in asymptomatic HIV-1 infection: The effects of age, education, ethnicity, and depression. Neuropsychology, 6, 303-313.
Lipsitz, J. D., Williams, J. B. W., Rabkin, J. G., Remien, R. H., Bradbury, M., el Sadr, W., Goetz, R., Sorrell, S., and Gorman, J. M. (1994). Psychopathology in male and female intravenous drug users with and without HIV infection. American Journal of Psychiatry, 151, 1662-1668.
Markova, L., and Forbes, C. (1984). Coping with haemophilia. International Review of Applied Psychology, 33, 457-477.
McNair, D. M., Lorr, M., and Droppleman, L. F. (1971). Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Services.
Nichols, S. (1985). Psychosocial reactions of persons with acquired immunodeficiency syndrome. Annals of Internal Medicine, 103, 765-767.
Ostrow, D. G., Monjan, A., Joseph, J., VanRaden, M., Fox, R., Kingsley, L., Dudley, J., and Phair, J. (1989). HIV related symptoms and psychological functioning in a cohort of homosexual men. American Journal of Psychiatry, 146, 737-742.
Pakenham, K. I., Dadds, M. R., and Terry, D. J. (1995). Psychosocial adjustment along the HIV disease continuum. Psychology and Health, 10, 523-536.
Pakesch, G., Loimer, N., Grunberger, J., Pfersmann, D., Linzmayer, L., and Mayerhofer, S. (1992). Neuropsychological findings and psychiatric symptoms in HIV-1 infected and non-infected drug users. Psychiatry Research, 41, 163-177.
Perdices, M., Dunbar, N., Grunseit, A., Hall, W., and Cooper, D. A. (1992). Anxiety, depression and HIV related symptomatology across the spectrum of HIV disease. Australian and New Zealand Journal of Psychiatry, 26, 560-566.
Pergami, A., Gala, C., Burgess, A., Durbano, F., Zanello, D., Riccio, M., Invernizzi, G., and Catalan, J. (1993). The psychosocial impact of HIV infection in women. Journal of Psychosomatic Research, 37, 687-696.
Pergami, A., Gala, C., Burgess, A., Invernizzi, G., and Catalan, J. (1994). Heterosexuals and HIV disease: a controlled investigation into the psychosocial factors associated with psychiatric morbidity. Journal of Psychosomatic Research, 38, 305-313.
Perkins, D. O., Stern, R. A., Golden, R. N., Murphy, C., Naftolowitz, D., and Evans, D. L. (1994). Mood disorders in HIV infection: Prevalence and risk factors in a nonepicenter of the AIDS epidemic. American Journal of Psychiatry, 151, 233-236.
Perry, S. W., and Markowitz, J. (1986). Psychiatric interventions for AIDS-spectrum disorders. Hospital and Community Psychiatry, 37, 1001, 1006.
Perry, S. W., and Tross, S. (1984). Psychiatric problems of AIDS inpatients at a New York hospital: Preliminary report. Public Health Reports, 99, 20-25.
Perry, S. W., Jacobsberg, L. B., Fishman, B., Frances, A., Bobo, J., and Jacobsberg, B. K. (1990). Psychiatric diagnosis before serological testing for human immunodeficiency virus. American Journal of Psychiatry, 147, 696-710.
Perry, S. W., Jacobsberg, L. B., Card, C. A., and Ashman, T. (1993). Severity of psychiatric symptoms after HIV testing. American Journal of Psychiatry, 150, 775-779.
Pugh, K., Riccio, M., Jadresic, D., Burgess, A. P., Baldeweg, T., Catalan, J., Lovett, E., Hawkins, D. A., Gruzelier, J., and Thompson, C. (1994). A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II. Psychological and health status at baseline and at 12 month follow up. Psychological Medicine, 24, 897-904.
Rabkin, J. G. (1996). Prevalence of psychiatric disorders in HIV illness. International Review of Psychiatry, 8, 157-166.
Rabkin, J. G., Williams, J. B., Neugebauer, R., Remien, R. H., and Goetz, R. (1990). Maintenance of hope in HIV spectrum homosexual men. American Journal of Psychiatry, 147, 1322-1326.
Rabkin, J. G., Williams, J. B., Remien, R. H., Goetz, R., Kertzner, R., and Gorman, J. M. (1991). Depression, distress, lymphocyte subsets, and human immunodeficiency virus symptoms on two occasions in HIV-positive homosexual men. American Journal of Psychiatry, 148, 111-119.
Rabkin, J. G., Johnson, J., Lin, S., Lipsitz, J. D., Remien, R. H., Williams, J. B., and Gorman, J. M. (1996). Psychopathology in male and female HIV-positive and HIV-negative intravenous drug users: Longitudinal course over three years. Manuscript submitted for publication.
Rabkin, J. G., Goetz, R. R., Remien, R. H., Williams, J. B., Todak, G., and Gorman, J. M. (1997). Stability of mood despite HIV illness progression in a group of homosexual men. American Journal of Psychiatry, 154, 231-238.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
Radloff, L. S., and Locke, B. Z. (1986). The community mental health assessment survey and CES-D scale. In M. M. Weissman, J. K. Meyers, and C. E. Ross (Eds.), Community surveys of psychiatric disorders (pp. 177-187). New Brunswick, NJ: Rutgers University Press.
Rosenberger, P. H., Bornstein, R. A., Nasrallah, H. A., Para, M. F., Whitaker, C. C., Fass, R. J., and Rice, Jr., R. R. (1993). Psychopathology in human immunodeficiency virus infection: Lifetime and current assessment. Comprehensive Psychiatry, 34, 150-158.
Rounsaville, B. J., Weissman, M. M., Rosenberger, P. H., Wilber, C. H., and Kleber, H. D. (1979). Detecting depressive disorders in drug abusers: A comparison of screening instruments. Journal of Affective Disorders, 1, 255-267.
Sayetta, R., and Johnson, D. (1980). Basic data on depressive symptomatology: United States 1974-75 (Vital and Health Statistics, Series 11, No. 216, DHEW Publication No. PHS 80-1666). Hyattsville, MD: National Center for Health Statistics.
Skoraszewski, M. J., Ball, J. D., and Mikulka, P. J. (1991). Neuropsychological functioning of HIV-infected males. Journal of Clinical and Experimental Neuropsychology, 13, 278-290.
Williams, J. B., Rabkin, J. G., Remien, R. H., Gorman, J. M., and Ehrhardt, A. A. (1991). Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection, II: Standardized clinical assessment of current and lifetime psychopathology. Archives of General Psychiatry, 48, 124-130.
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Griffin, K.W., Rabkin, J.G. Psychological Distress in People with HIV/AIDS: Prevalence Rates and Methodological Issues. AIDS Behav 1, 29–42 (1997). https://doi.org/10.1023/A:1026261820964
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DOI: https://doi.org/10.1023/A:1026261820964