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Am J Psychiatry 1993; 150:775-779
Copyright © 1993 by American Psychiatric Association
Severity of psychiatric symptoms after HIV testing
S Perry, L Jacobsberg, CA Card, T Ashman, A Frances and B Fishman
HIV Clinical Research Program, Cornell University Medical College, New York.
OBJECTIVE: The authors were interested in the psychiatric effects of
serological testing for HIV and what information feasibly available at
intake might predict more severe psychiatric symptoms 1 year later. METHOD:
HIV testing in a private office setting was offered to adults at perceived
risk for HIV infection but without AIDS. At entry, then 6 and 12 months
later, subjects were counseled by psychiatric nurses and assessed by the
Hamilton Rating Scale for Depression, Beck Depression Inventory,
Spielberger State-Trait Anxiety Inventory, and Brief Symptom Inventory.
RESULTS: Mean scores on all measures of psychiatric symptoms were lower at
follow-up among both 106 HIV-positive and 222 HIV- negative adults. One
year after HIV testing, 121 (37%) of the 328 subjects had scores associated
with psychopathology. These elevated scores were not predicted by
serostatus but by initial psychopathological scores (N = 150), annual
income less than +15,000 (N = 114), being female (N = 46), and history of
injection drug use (N = 32) and heterosexual risk factors (N = 60) as
compared to males having sex with males (N = 236). CONCLUSIONS: Before the
development of more severe physical symptoms, on average, knowledge of HIV
infection does not increase psychiatric morbidity; however, regardless of
serostatus, a notable percentage of at-risk adults have sustained high
levels of psychiatric symptoms. Counseling during the HIV testing process
provides an opportunity to identify these individuals for closer study and
indicated psychiatric treatment.
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