Sahota Puneet Chawla, Cakouros Brigid E, Russell Rachel, Hassler Michael, Blank Michael B, Barg Frances K
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Second Floor, Philadelphia, PA, 19104, USA.
School of Public Health, University of California, Berkeley, Berkeley, USA.
Community Ment Health J. 2020 Feb;56(2):338-347. doi: 10.1007/s10597-019-00466-w. Epub 2019 Sep 18.
The purpose of this study was to identify causal pathways between HIV infection and severe mental illness. Data were collected through open-ended, semi-structured interviews. An integrated approach to the analysis, using inductive and deductive coding, was used to identify patterns among respondents. Standardized instruments were used to characterize the sample in terms of risk behaviors, physical and mental functioning and depression. Twenty-six men and women with a diagnosis of HIV and unipolar depression (n = 11) or schizophrenia/schizoaffective versus bipolar disorder (n = 15) participated. For persons with unipolar depression, the HIV diagnosis often preceded depressive symptoms. For persons with schizophrenia/schizoaffective versus bipolar disorder, mania and psychosis symptoms often preceded HIV. Substance use, incarceration and adverse childhood experiences were common across diagnoses. Attention to the directionality of effects between mental illness and HIV has important implications for anticipatory guidance for infectious disease specialists, primary care providers and public health practitioners as well as policymakers.
本研究的目的是确定HIV感染与严重精神疾病之间的因果途径。数据通过开放式、半结构化访谈收集。采用归纳和演绎编码的综合分析方法来识别受访者中的模式。使用标准化工具从风险行为、身心功能和抑郁方面对样本进行特征描述。26名被诊断为HIV且患有单相抑郁症（n = 11）或精神分裂症/分裂情感障碍与双相情感障碍（n = 15）的男性和女性参与了研究。对于单相抑郁症患者，HIV诊断通常先于抑郁症状出现。对于患有精神分裂症/分裂情感障碍与双相情感障碍的患者，躁狂和精神病症状通常先于HIV出现。物质使用、监禁和不良童年经历在各诊断组中都很常见。关注精神疾病与HIV之间影响的方向性对传染病专家、初级保健提供者、公共卫生从业者以及政策制定者的预期指导具有重要意义。
