Baillargeon J G, Paar D P, Wu H, Giordano T P, Murray O, Raimer B G, Avery E N, Diamond P M, Pulvino J S
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1006, USA.
AIDS Care. 2008 Jan;20(1):124-9. doi: 10.1080/09540120701426532.
Psychiatric disorders such as bipolar disorder, schizophrenia and depression have long been associated with risk behaviors for HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV). The US prison population is reported to have elevated rates of HIV, hepatitis and most psychiatric disorders. This study examined the association of six major psychiatric disorders with HIV mono-infection, HIV/HCV co-infection and HIV/HBV co-infection in one of the nation's largest prison populations. The study population consisted of 370,511 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 2003 and July 1, 2006. Information on medical conditions and sociodemographic factors was obtained from an institution-wide electronic medical information system. Offenders diagnosed with HIV mono-infection, HIV/HCV, HIV/HBV and all HIV combined exhibited elevated rates of major depression, bipolar disorder, schizophrenia, schizoaffective disorder, non-schizophrenic psychotic disorder and any psychiatric disorder. In comparison to offenders with HIV mono-infection, those with HIV/HCV co-infection had an elevated prevalence of any psychiatric disorder. This cross-sectional study's finding of positive associations between psychiatric disease and both HIV infection and hepatitis co-infection among Texas prison inmates holds both clinical and public health relevance. It will be important for future investigations to examine the extent to which psychiatric disorders serve as a barrier to medical care, communication with clinicians and adherence to prescribed medical regimens among both HIV-mono-infected and HIV/hepatitis-co-infected inmates.
双相情感障碍、精神分裂症和抑郁症等精神疾病长期以来一直与感染艾滋病毒、丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）的风险行为相关。据报道，美国监狱人口中艾滋病毒、肝炎和大多数精神疾病的发病率较高。本研究调查了美国最大监狱人口之一中六种主要精神疾病与艾滋病毒单一感染、艾滋病毒/丙型肝炎病毒合并感染和艾滋病毒/乙型肝炎病毒合并感染之间的关联。研究人群包括370511名得克萨斯州刑事司法部的囚犯，他们在2003年1月1日至2006年7月1日期间被监禁了任何时长。有关医疗状况和社会人口学因素的信息来自全机构范围的电子医疗信息系统。被诊断为艾滋病毒单一感染、艾滋病毒/丙型肝炎病毒、艾滋病毒/乙型肝炎病毒以及所有艾滋病毒合并感染的罪犯，其重度抑郁症、双相情感障碍、精神分裂症、分裂情感性障碍、非精神分裂性精神障碍和任何精神疾病的发病率均有所升高。与艾滋病毒单一感染的罪犯相比，艾滋病毒/丙型肝炎病毒合并感染的罪犯中任何精神疾病的患病率更高。这项横断面研究发现，得克萨斯州监狱囚犯中精神疾病与艾滋病毒感染和肝炎合并感染之间存在正相关，这具有临床和公共卫生意义。对于未来的调查而言，研究精神疾病在多大程度上成为艾滋病毒单一感染和艾滋病毒/肝炎合并感染囚犯获得医疗护理、与临床医生沟通以及坚持规定医疗方案的障碍，将是很重要的。
