Am J Psychiatry 1993; 150:309-315
Copyright © 1993 by American Psychiatric Association
Personality disorder in patients infected with HIV: a controlled study with implications for clinical care
DO Perkins, EJ Davidson, J Leserman, D Liao and DL Evans
Department of Psychiatry, University of North Carolina School of Medicine.
OBJECTIVE: Previous studies of psychiatric illness in populations infected
with or at risk for HIV have not included systematic evaluation for
personality disorders. The authors present the first controlled study of 1)
personality disorders in HIV-positive and HIV- negative homosexual men and
2) the impact of personality disorder on coping, social support, and mood
in asymptomatic HIV-positive homosexual men. METHOD: The authors studied 58
asymptomatic HIV- positive and 53 HIV-negative homosexual men living
outside the high- prevalence epicenters of the AIDS epidemic. Personality
disorder was assessed with a clinician-administered interview, the
Structured Clinical Interview for DSM-III-R. RESULTS: There was a
significantly higher prevalence of personality disorder in the HIV-positive
(33%) than in the HIV-negative (15%) subjects. In the HIV-positive
subjects, those with a personality disorder (compared to those without a
personality disorder) showed 1) significantly greater mood disturbance,
with higher scores on the Hamilton Rating Scale for Depression, Hamilton
Rating Scale for Anxiety, Profile of Mood States Total Mood Dysfunction,
and the Beck Hopelessness Scale, 2) greater use of denial and helplessness
when coping with the threat of AIDS, and 3) greater social conflict.
CONCLUSIONS: These findings suggest that personality disorder is common in
the HIV-positive population. Compared with HIV- infected patients without a
personality disorder, patients with a personality disorder may experience
greater dysphoria and be more likely to cope with the threat of AIDS in a
dysfunctional way. Recognition of the impact of personality disorder on
coping with HIV infection is important for comprehensive, sensitive, and
effective clinical care.
