Freeman M, Nkomo N, Kafaar Z, Kelly K
Human Sciences Research Council, Pretoria, South Africa.
AIDS Care. 2007 Nov;19(10):1201-9. doi: 10.1080/09540120701426482.
The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7%--though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services.
该研究考察了精神障碍的存在与一系列独立变量之间的关联。对900名艾滋病毒呈阳性的个体进行了综合国际诊断访谈，以确定所选精神障碍的存在情况。通过结构化访谈评估了所获得的支持以及可能导致精神障碍的因素。精神障碍的总体患病率为43.7%，不过在疾病的3期（49.7%）和4期（68%）中患病率更高。18% 的受访者正在接受抗逆转录病毒治疗。接受检测前和检测后的咨询与精神障碍无关；咨询的次数、咨询师的专业地位以及对咨询的感知帮助程度也与之无关。加入艾滋病毒支持小组与精神障碍的存在有关，尽管参加小组的频率与之无关。虽然大多数披露自己艾滋病毒感染状况的人认为这一经历是有益的，但精神障碍的存在与披露艾滋病毒呈阳性状况之间存在显著正相关。虽然成为艾滋病毒/艾滋病感染者协会成员和信教被认为是有益的，但两者在统计学上均与精神障碍的存在无关。社区和家庭的歧视以及孤立与精神障碍有关。因艾滋病失去重要他人与精神障碍有关。研究结果表明，作为艾滋病护理的一部分，迫切需要提供精神科护理并加强支持服务。
