Document Detail


Psychological effects of HAART: a 2-year study.
MedLine Citation:
PMID:  10845355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objectives of this study were to evaluate the psychological consequences of combination antiretroviral treatment in terms of mood, hope, and life satisfaction in men with symptomatic human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome and to compare those whose health improved with those whose health did not improve. METHODS: One hundred seventy-three HIV+ gay or bisexual men with symptomatic HIV illness (40% nonwhite) were evaluated semiannually in a university-affiliated research program between July 1995 and December 1997. The primary outcome measures were the Structured Clinical Interview for DSM-IV, Beck Depression Inventory, Endicott Quality of Life Enjoyment and Satisfaction Questionnaire, and Beck Hopelessness Scale. RESULTS: Psychological distress in this sample was mild to moderate at baseline. During the first 2 years that highly active antiretroviral therapy became widely available, we observed a statistically significant but clinically modest reduction in distress in the sample as a whole, with significant covariates of CD4 cell count, HIV symptoms, and social support in a mixed-effects model. Rates of clinical depression declined. However, this generalized mental health improvement was not related to individual medical improvement of markers of HIV illness progression; those classified as improved were no more likely than those who remained unimproved to report greater declines in measures of distress and hopelessness. Number of self-reported physical symptoms were directly related to distress levels. CONCLUSIONS: A cohort effect was observed, with overall psychological improvement. Physical symptoms were more strongly related to psychological distress than were laboratory markers. Consequently, those whose CD4 cell count and HIV RNA viral load reflected successful treatment were no more likely than others to be relieved of the psychological burdens of illness.
Authors:
J G Rabkin; S J Ferrando; S H Lin; M Sewell; M McElhiney
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Psychosomatic medicine     Volume:  62     ISSN:  0033-3174     ISO Abbreviation:  Psychosom Med     Publication Date:    2000 May-Jun
Date Detail:
Created Date:  2000-10-04     Completed Date:  2000-10-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  413-22     Citation Subset:  IM; X    
Affiliation:
Department of Psychiatry, Weill College of Medicine, Cornell University, Ithaca, NY, USA. jgr1@Columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antigens, CD4 / immunology
Antiviral Agents / therapeutic use*
Depression / diagnosis*,  etiology*
Disease Progression
Follow-Up Studies
HIV Seropositivity / drug therapy*,  immunology,  psychology*
Humans
Male
Patient Satisfaction
Psychiatric Status Rating Scales
Quality of Life
Questionnaires
Severity of Illness Index
Social Support
Somatoform Disorders / diagnosis,  etiology
Grant Support
ID/Acronym/Agency:
R01 MH42277/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antigens, CD4; 0/Antiviral Agents

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