OBJECTIVE: This study examined the relationship of the somatic symptoms
fatigue and insomnia with indicators of both psychiatric disturbance and
HIV disease severity. METHOD: Study participants were 98 asymptomatic
HIV-infected and 71 uninfected homosexual men; 82 HIV- infected and 64
uninfected men had 6-month follow-up examinations. Scales from the
self-reported Profile of Mood States measured fatigue and dysphoric mood.
Major depression diagnosis was determined by the Structured Clinical
Interview for DSM-III-R. Selected items from the Hamilton depression and
anxiety scales measured insomnia and other symptoms of depression.
Performance on a battery of standardized tests determined
neuropsychological function ratings. RESULTS: At study entry, complaints of
fatigue and insomnia were associated with dysphoric mood, major depression,
and other non-HIV-related symptoms of major depression but not with CD4
cell counts or neuropsychological functioning. Increases in levels of
fatigue and insomnia over the 6- month follow-up period were associated
with increases in non-HIV- related symptoms of depression and in severity
of dysphoric mood. Increases in fatigue were also associated with
decrements in motor functioning. Otherwise, fatigue or insomnia were not
associated with HIV disease progression. CONCLUSIONS: These findings
suggest that complaints of fatigue and insomnia in otherwise asymptomatic
HIV- infected patients are likely to be related to psychological
disturbances and possibly major depression, which can be treated. HIV-
infected patients who complain of fatigue or insomnia should routinely be
assessed for major depression.