Catalan J, Klimes I, Bond A, Day A, Garrod A, Rizza C
Department of Psychiatry, Charing Cross and Westminster Medical School, London.
J Psychosom Res. 1992 Jul;36(5):409-16. doi: 10.1016/0022-3999(92)90001-i.
The aim of the investigation was to establish the prevalence of psychosocial problems in men with haemophilia and HIV infection, and to identify factors associated with psychological morbidity. A cross-sectional controlled study including 37 HIV seropositive and 36 HIV seronegative men with haemophilia under the care of the Oxford Haemophilia Centre were included in the investigation. The outcome measures included current psychological status (PSE, POMS, Beck Hopelessness Scale and Self-Esteem) and psychiatric history; coping and health beliefs (Self-Control Schedule, Hardiness Scale, Health Locus of Control Scale); social functioning (Modified Social Adjustment Scale); and sexual functioning. The results showed that seropositive individuals, whether symptomatic or not, had significantly worse total PSE scores and had higher levels of hopelessness. In addition, symptomatics had worse depression scores (POMS) than seronegatives. However, levels of psychiatric morbidity were generally low, even in the seropositive group. High levels of psychological morbidity were associated with high levels of hopelessness, unfavourable social adjustment, past psychiatric history and symptomatic HIV disease. Seropositives reported greater negative impact on their sex lives, and sexually active seropositives reported a significantly greater prevalence of sexual dysfunction than seronegatives. The majority of seropositives reported regular condom use during intercourse, and also continuing concerns about infecting their sexual partners in spite of it. In summary, it was found that men with haemophilia an HIV infection have higher levels of psychological distress and sexual problems than seronegatives. The skilled staff involved in their treatment are in a good position to identify their difficulties and ensure that good care is provided.
该调查的目的是确定血友病合并艾滋病毒感染男性心理社会问题的患病率，并确定与心理疾病相关的因素。一项横断面对照研究纳入了牛津血友病中心照料下的37名艾滋病毒血清阳性和36名艾滋病毒血清阴性的血友病男性。结果指标包括当前心理状态（PSE、POMS、贝克绝望量表和自尊量表）和精神病史；应对方式和健康信念（自我控制量表、坚韧力量表、健康控制点量表）；社会功能（改良社会适应量表）；以及性功能。结果显示，血清阳性个体，无论有无症状，其PSE总分显著更差，绝望程度更高。此外，有症状者的抑郁得分（POMS）比血清阴性者更差。然而，精神疾病的发病率总体较低，即使在血清阳性组中也是如此。高水平的心理疾病与高绝望程度、不良社会适应、既往精神病史和有症状的艾滋病毒疾病相关。血清阳性者报告其性生活受到的负面影响更大，有性活动的血清阳性者报告性功能障碍的患病率显著高于血清阴性者。大多数血清阳性者报告在性交时经常使用避孕套，尽管如此，他们仍持续担心感染性伴侣。总之，研究发现，血友病合并艾滋病毒感染的男性比血清阴性者有更高水平的心理困扰和性问题。参与其治疗的专业人员很适合识别他们的困难，并确保提供良好的护理。
