O'Dowd M A, McKegney F P
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10467.
Gen Hosp Psychiatry. 1990 Jan;12(1):50-5. doi: 10.1016/0163-8343(90)90038-e.
To identify similarities and differences between AIDS patients and non-AIDS patients, all psychiatric consultations done in one year in a large voluntary general hospital were reviewed. A total of 93 consultations were done on 67 AIDS patients and 138 consultations were done on 121 comparably aged patients without AIDS. The most common AIDS risk factor was intravenous drug use. The AIDS patients were more likely to be Hispanic and male than were the non-AIDS patients. The AIDS group was also more likely to have a diagnosis of organic mental disorder, particularly dementia. There were no other differences in Axis I diagnoses, including depression, substance abuse, and adjustment disorder. Suicidal risk was no greater in the AIDS patients than in the non-AIDS patients. Axis II diagnoses were made more often in the non-AIDS patients, who also required more one-to-one nursing supervision. Consultation in AIDS patients took more staff time, and AIDS patients were more likely to have required one or more repeat consultations within the period of the study, thus creating a heavier burden on consultation staff. Although these predominantly heterosexual, Hispanic, and drug-using hospitalized AIDS patients do not show significantly higher rates of psychiatric morbidity than other, non-AIDS patients, except for more organic mental disorders, AIDS seems to create a much higher demand for psychiatric consultation services.
为了确定艾滋病患者与非艾滋病患者之间的异同,我们回顾了一家大型志愿综合医院一年内进行的所有精神科会诊。对67名艾滋病患者进行了共计93次会诊,对121名年龄相仿的非艾滋病患者进行了138次会诊。最常见的艾滋病危险因素是静脉注射吸毒。艾滋病患者比非艾滋病患者更有可能是西班牙裔和男性。艾滋病组也更有可能被诊断为器质性精神障碍,尤其是痴呆症。在轴I诊断方面,包括抑郁症、药物滥用和适应障碍,没有其他差异。艾滋病患者的自杀风险并不比非艾滋病患者更高。轴II诊断在非艾滋病患者中更常见,他们也需要更多一对一的护理监督。艾滋病患者的会诊需要更多的工作人员时间,并且在研究期间,艾滋病患者更有可能需要一次或多次重复会诊,从而给会诊工作人员带来更沉重的负担。尽管这些主要为异性恋、西班牙裔且吸毒的住院艾滋病患者,除了更多的器质性精神障碍外,与其他非艾滋病患者相比,并未表现出明显更高的精神疾病发病率,但艾滋病似乎对精神科会诊服务产生了更高的需求。