Baillargeon Jacques, Ducate Suzanne, Pulvino John, Bradshaw Patrick, Murray Owen, Olvera Rene
Center for Epidemiology and Biostatistics/Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX 78284-7802, USA.
Ann Epidemiol. 2003 Oct;13(9):606-12. doi: 10.1016/S1047-2797(03)00061-9.
Psychiatric disorders, such as bipolar disorder, schizophrenia, and depression, have been associated with both HIV-associated risk behaviors and HIV infection. While the US prison population is reported to exhibit elevated rates of HIV/AIDS and most psychiatric disorders, scarce information currently exists on the association of these conditions in the prison setting. The present study examined the association of six major psychiatric disorders with HIV infection in one of the nation's largest prison populations.
The study population consisted of 336,668 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 1999 and December 31, 2001. Information on medical conditions and sociodemographic factors was obtained from an institution-wide medical information system.
Inmates diagnosed with HIV infection exhibited elevated rates of major depression, dysthymia, bipolar disorder, schizophrenia, schizoaffective disorder, and non-schizophrenic psychotic disorder. These rates persisted in stratified analyses and in a multivariate analysis that statistically adjusted for gender, race, and age category.
The present cross-sectional study's finding of a positive association between HIV infection and psychiatric diagnoses among inmates holds both clinical and public health relevance. It will be important for future investigations to prospectively assess the underlying mechanisms of these associations in the correctional setting.
双相情感障碍、精神分裂症和抑郁症等精神疾病与艾滋病相关的危险行为及艾滋病毒感染均有关联。虽然据报道美国监狱人口中艾滋病毒/艾滋病和大多数精神疾病的发病率有所上升，但目前关于监狱环境中这些疾病之间关联的信息却很匮乏。本研究在全国最大的监狱人口之一中，考察了六种主要精神疾病与艾滋病毒感染之间的关联。
研究人群包括336,668名得克萨斯州刑事司法部的囚犯，他们在1999年1月1日至2001年12月31日期间被关押了不同时长。医疗状况和社会人口学因素的信息来自全机构范围的医疗信息系统。
被诊断为感染艾滋病毒的囚犯中，重度抑郁症、心境恶劣、双相情感障碍、精神分裂症、分裂情感性障碍和非精神分裂性精神障碍的发病率较高。这些发病率在分层分析以及对性别、种族和年龄类别进行统计学调整的多变量分析中依然存在。
本横断面研究发现囚犯中艾滋病毒感染与精神疾病诊断之间存在正相关，这具有临床和公共卫生意义。未来的调查前瞻性地评估教养环境中这些关联的潜在机制将很重要。
