Multidisciplinary Baseline Assessment of Homosexual Men With and Without Human Immunodeficiency Virus Infection

Gorman, Jack M.; Kertzner, Robert M.; Todak, George; Goetz, Raymond R.; Williams, Janet B. W.; Rabkin, Judith G.; Meyer‐Bahlburg, Heino F. L.; Mayeux, Richard; Stern, Yaakov; Lange, Michael; Dobkin, Jay F.; Spitzer, Robert M.; Ehrhardt, Anke Α.

doi:10.1001/archpsyc.1991.01810260028004

Cited by 50 publications

(11 citation statements)

References 12 publications

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“…First, there are limitations imposed by the methods of recruitment and the development of a convenience sample. This approach is consistent with those taken in major international studies of psychiatric morbidity in HIV infection [26] and is similar to methods that have even been recommended by some authors to enable recruitment across a sufficiently broad base of the population [44,45]. Kaslow et al [46] and others [44] have argued that since the socio-demographic characteristics of the homosexual and bisexual individuals are largely unknown, there exists no adequate sampling frame to enable satisfactory representation.…”

Section: General Theoretical and Methodological Issuesmentioning

confidence: 59%

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Psychiatric Disorder in HIV Infection

Kelly

Raphael

Judd

et al. 1998

Aust N Z J Psychiatry

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Objective: This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. Method: A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIVt) (79 CDC stage 11/111 and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version lllR (DIS-IIIR). Results: Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuseldependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. Conclusions: Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men, In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis, The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.

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Section: General Theoretical and Methodological Issuesmentioning

confidence: 59%

“…Subjects were then referred to the research staff. This recruitment of a convenience sample is similar to methods used in major international studies of psychiatric morbidity in HIV infection [26].…”

Section: Methodsmentioning

confidence: 99%

Psychiatric Disorder in HIV Infection

Kelly

Raphael

Judd

et al. 1998

Aust N Z J Psychiatry

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“…Details of the study design have been published previously (5). In brief, all of the men had known their HIV status (confirmed at study baseline) for at least 1 month before study entry, did not have an AIDS-defining condition according to the 1987 criteria of the Centers for Disease Control (CDC) or another serious neurological or medical condition, and were not intravenous drug users.…”

Section: Methodsmentioning

confidence: 99%

Stability of mood despite HIV illness progression in a group of homosexual men

Rabkin

Goetz²,

Remien³

et al. 1997

AJP

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B oth doctors and patients often assume that people with terminal illnesses are apt to become clinically depressed, especially as death approaches. Rarely, however, has this assumption been studied systematically or prospectively. Our data allow us to shed some light on whether clinical depression is an inevitable or even likely concomitant of fatal illness.While several large studies have generated prevalence rates of mood disorders among HIV-positive and HIVnegative men and women on a cross-sectional basis, there is a paucity of information about longitudinal changes in rates of either syndromal disorders or psychiatric symptoms as HIV illness progresses. Joseph et al. (1) found stable scores over six semiannual occasions on self-rating scales of depression in the Chicago Multicenter AIDS Cohort Study group, despite HIV illness progression. Perry et al. (2) followed 328 homosexual and heterosexual men and women, both HIV negative and HIV positive, who sought HIV antibody testing. Over a 1-year period, they found a decline in severity of depressive symptoms on both clinician-and self-rated scales, but no difference between HIV-positive and HIV-negative subjects on any occasion.A pair of studies (3, 4), published in the Journal of the American Medical Association, followed community cohorts of homosexual men semiannually since 1985. Both used the same self-report screening scale for mood problems (Center for Epidemiologic Studies Depression [CES-D] Scale). Neither study found a significant relation between CES-D Scale scores and the time to either diagnosis of AIDS or death, although they differed regarding the effect of depressive symptoms on the rate of decline of CD4 cells.

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“…The recruitment and baseline characteristics of this cohort have been previously described. 3 Two hundred seven homosexual and bisexual men were recruited in late 1987 and early 1988 to participate in a 5-year follow-up study of HIV-infected subjects (n = 123) and HIV-controls (n = 84). The majority of subjects were recruited by word of mouth; two announcements were placed in gay-oriented monthly newsletters and one in a newspaper.…”

mentioning

confidence: 99%

“…At each visit, subjects received a stan-dardized inedical examination for the purpose of staging, and also received neurologic, neuropsychological, psychiatric, and psychosexual assessn1ents. These assess1nents have been described previously 1 , 3 ; relevant assessn1ents are summarized below. Medical assessment.…”

mentioning

confidence: 99%

Neuropsychological Changes in a Prospectively Followed Cohort of Homosexual and Bisexual Men With and Without HIV Infection

Stern¹,

Liu²,

Marder³

et al. 1995

Neurology

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We evaluated neuropsychological test performance of 168 homosexual and bisexual men with and without human immunodeficiency virus (HIV) infection (113 HIV+ subjects and 55 HIV- controls) over 4.5 years of semiannual follow-up. Analyses of the longitudinal data were performed by applying generalized estimating equations (GEEs) to regression analyses with repeated measures. Compared with the HIV- men, the HIV+ subjects performed more poorly on memory testing. Performance on all tests tended to improve over time, but this improvement was attenuated or eliminated in the HIV+ group for tests of language and attention. Within the HIV+ subjects, improvement over time in tests of memory, executive function, language, and attention was attenuated or eliminated in patients with lower CD4 levels; more advanced HIV disease was associated with poorer memory and executive function and with attenuated or reduced learning effects for memory, motor speed, and language tests. Clinically significant neurologic findings were associated with worse memory and orientation and with attenuated or reversed learning effects for memory, language, and attention tests. There were 33 deaths in the HIV+ group. In the men who died, there was more rapid decline in executive, language, and attentional test performance. These observations remained significant after controlling for HIV disease severity. We conclude that HIV infecting the CNS results in progressive cognitive change that is closely associated with neurologic findings. In addition, our findings suggest a relation between more rapid cognitive progression and death.

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Multidisciplinary Baseline Assessment of Homosexual Men With and Without Human Immunodeficiency Virus Infection

Cited by 50 publications

References 12 publications

Psychiatric Disorder in HIV Infection

Psychiatric Disorder in HIV Infection

Stability of mood despite HIV illness progression in a group of homosexual men

Neuropsychological Changes in a Prospectively Followed Cohort of Homosexual and Bisexual Men With and Without HIV Infection

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