Skip to main content
SpringerLink
Log in

Clinical Management of Psychiatric Disorders in Patients with HIV Disease

  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

HIV disease presents considerable challenges that can affect adjustment and health-related behaviors. This article provides an overview of clinical considerations in the treatment of comorbid psychiatric disorders and problems in adjustment in HIV patients. First, the research literature is reviewed with respect to biomedical, intrapersonal, and psychosocial factors associated with HIV-related psychological adjustment and psychiatric complications. Next, a brief description is presented regarding prevalence and types of co-occurring psychiatric disorders seen in HIV patients. The article concludes with a discussion of clinical assessment and treatment considerations for psychiatric clinicians who work with HIV patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Perry SW, Tross S: Psychiatric problems of AIDS inpatients at the New York hospital: Preliminary report. Public Health Reports 99:200-205, 1984.

    Google Scholar 

  2. Leiberich P, Engeter M, Olbrich E, et al: Longitudinal development of distress, coping and quality of life in HIV-positive persons. Psychotherapy & Psychosomatics 66: 237-247, 1997.

    Google Scholar 

  3. Perry S, Jacobsberg L, Card CAL, et al: Severity of psychiatric symptoms after HIV testing. American Journal of Psychiatry 150:775-779, 1993.

    Google Scholar 

  4. Lyketsos CG, Hoover DR, Guccione MMS, et al: Changes in depressive symptoms as AIDS develops. American Journal of Psychiatry 153:1430-1437, 1996.

    Google Scholar 

  5. Krikorian R, Kay J, Liang WM: Emotional distress, coping, and adjustment in human immunodeficiency virus and acquired immune deficiency syndrome. The Journal of Nervous and Mental Disease 183:293-298, 1995.

    Google Scholar 

  6. Griffin KW, Rabkin JG, Remien RH et al: Disease severity, physical limitations and depression in HIV-infected men. Journal of Psychosomatic Research 44:219-227, 1998.

    Google Scholar 

  7. Rabkin JG, Ferrando SJ, Lin SH et al: Psychological effects of HAART: A 2-year study. Psychosomatic Medicine 62:413-422, 2000.

    Google Scholar 

  8. Catalan J, Klimes I, Day A, et al: The psychosocial impact of HIV infection in gay men: A controlled investigation and factors associated with psychiatric morbidity. British Journal of Psychiatry 161:774-778, 1992.

    Google Scholar 

  9. Johnson JG, Williams JBW, Rabkin JG et al: Axis I psychiatric symptoms associated with HIV infection and personality disorder. American Journal of Psychiatry 152:551-554, 1995.

    Google Scholar 

  10. Taylor SE, Kemeny ME, Aspinwall LG et al: Optimism, coping, psychological distress, and high-risk sexual behavior among men at risk for acquired immune defi-ciency syndrome (AIDS). Journal of Personality and Social Psychology 63:460-473, 1992.

    Google Scholar 

  11. Clement U, Schoennesson LN: Subjective HIV attribution theories, coping, and psychological functioning among homosexual men with HIV. AIDS Care 10:355-363, 1998.

    Google Scholar 

  12. Farber EW, Schwartz JAJ, Schaper PE, et al: Resilience factors associated with adaptation to HIV disease. Psychosomatics 41:140-146, 2000.

    Google Scholar 

  13. Blaney NT, Goodkin K, Feaster D, et al: A psychosocial model of distress over time in early HIV-1 infection: The role of life stressors, social support and coping. Psychology & Health 12:633-653, 1997.

    Google Scholar 

  14. Vassend O, Eskild A: Psychological distress, coping, and disease progression in HIV-positive homosexual men. Journal of Health Psychology 3:243-257, 1999.

    Google Scholar 

  15. Leserman J, Petitto JM, Golden RN, et al: Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS. American Journal of Psychiatry 157:1221-1228, 2000.

    Google Scholar 

  16. Schwartzberg SS: Struggling for meaning: How HIV-positive gay men make sense of AIDS. Professional Psychology: Research and Practice 24:483-490, 1993.

    Google Scholar 

  17. Bower JE, Kemeny ME, Taylor, SE et al: Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. Journal of Consulting and Clinical Psychology 66:979-986, 1998.

    Google Scholar 

  18. Carels RA, Baucom DH, Leone P, et al: Psychosocial factors and psychological symptoms: HIV in a public health setting. Journal of Community Psychology 26:145-162, 1998.

    Google Scholar 

  19. Pakenham KI, Dadds MR, Terry DJ: Relationships between adjustment to HIV and both social support and coping. Journal of Consulting and Clinical Psychology 62:1194-1203, 1994.

    Google Scholar 

  20. Lyketsos CG, Hutton H, Fishman M, et al: Psychiatric morbidity on entry to an HIV primary care clinic. AIDS 10:1033-1039, 1996.

    Google Scholar 

  21. Goodkin K, Baldewicz, TT, Wilkie FL, et al: Cognitive-motor impairment and disorder in HIV-1 infection. Psychiatric Annals 31:37-44, 2001.

    Google Scholar 

  22. Lyketsos CG, Treisman GJ: Mood disorders in HIV infection. Psychiatric Annals 1:45-49, 2001.

    Google Scholar 

  23. Ciesla JA, Roberts JE: Meta-analysis of the relationship between HIV infection and risk for depressive disorders. American Journal of Psychiatry 158:725-730, 2001.

    Google Scholar 

  24. McDaniel JS, Chung JY, Brown L, et al: Practice guideline for the treatment of patients with HIV/AIDS. American Journal of Psychiatry 157(Suppl 11):1-62, 2000.

    Google Scholar 

  25. Berghuis JP, Uldall KK, Lalonde B: Validity of two scales in identifying HIV-associated dementia. Journal of Acquired Immune Deficiency Syndrome 12:134-140, 1999.

    Google Scholar 

  26. Ferrando SJ: Substance abuse and HIV infection. Psychiatric Annals 31:57-62, 2001.

    Google Scholar 

  27. Perkins DO, Leserman J, Stern RA et al: Somatic symptoms and HIV infection: Relationship to depressive symptoms and indicators of HIV disease. American Journal of Psychiatry 152:1776-1781, 1995.

    Google Scholar 

  28. Farber EW, McDaniel JS: Assessment and psychotherapy practice implications of new combination antiviral therapies for HIV disease. Professional Psychology: Research and Practice 30:173-179, 1999.

    Google Scholar 

  29. Leserman J, Petitto JM, Perkins DO, et al: Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men: A 2-year follow-up study. Archives of General Psychiatry 54:279-285, 1997.

    Google Scholar 

  30. Gillenwater DR, McDaniel JS: Rational psychopharmacology for patients with HIV infection and AIDS. Psychiatric Annals 31:28-34, 2001.

    Google Scholar 

  31. Cozza KL, Armstrong SC: The Cytochrome P450 System: Drug Interaction Principles for Medical Practice. Washington, DC, American Psychiatric Publishing, Inc., 2001.

    Google Scholar 

  32. Lutgendorf SK, Antoni MH, Ironson G et al: Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men. Psychosomatic Medicine 60:204-214, 1998.

    Google Scholar 

  33. Markowitz JC, Kocsis JH, Fishman B et al: Treatment of depressive symptoms in human immunodeficiency virus-positive patients. Archives of General Psychiatry 55:452-457, 1998.

    Google Scholar 

  34. Blechner MJ: Psychodynamic approaches to HIV and AIDS, in Hope and Mortality: Psychodynamic Approaches to AIDS and HIV (pp. 3-62). Edited by Blechner MJ. Hillsdale, NJ, Analytic Press, 1997.

    Google Scholar 

  35. Farber EW: Existentially informed HIV-related psychotherapy. In: Massey RF, Massey SD, eds., Editor-in-Chief: Kaslow F. Comprehensive Handbook of Psychotherapy, Vol. III: Interpersonal, Humanistic, Existential. New York, John Wiley & Sons, in press.

  36. Empfield M: Working with HIV-infected people. In: Cournos F, Bakalar N, eds., AIDS and People with Severe Mental Illness. New Haven: Yale University Press, 1996, pp. 148-159.

    Google Scholar 

  37. Noring S, Dubler NN, Birkhead G, et al.: A new paradigm for HIV care: Ethical and clinical considerations. American Journal of Public Health 91:690-694, 2001.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, USA

    Eugene W. Farber (Associate Professor)

  2. Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, USA

    J. Stephen McDaniel (Professor)

Authors
  1. Eugene W. Farber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Stephen McDaniel
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Farber, E.W., McDaniel, J.S. Clinical Management of Psychiatric Disorders in Patients with HIV Disease. Psychiatr Q 73, 5–16 (2002). https://doi.org/10.1023/A:1012836516826

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1012836516826

Search

Navigation