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¿Ha habido una disminución en la prevalencia de los trastornos del estado de ánimo en los individuos seropositivos al VIH desde la introductión de la terapia de combinación?

Published online by Cambridge University Press:  12 May 2020

A. Alciati
Affiliation:
Departamento de Psiquiatría, Hospital L Sacco, Milán, ltalia;
F. Starace
Affiliation:
Servicio de Consulta Psiquiátrica, Hospital D. Cotugno θ Instituto de Psiquiatría, Universidad de Nápoles, SUN, ltalia;
B. Scaramelli
Affiliation:
Departamento de Psiquiatría, Hospital L Sacco, Milán, ltalia;
M. Campaniello
Affiliation:
Segundo Departamento de Enfermedades Infecciosas, Hospital L Sacco, Milán, ltalia
B. Adriani
Affiliation:
Segundo Departamento de Enfermedades Infecciosas, Hospital L Sacco, Milán, ltalia
C. Mellado
Affiliation:
Segundo Departamento de Enfermedades Infecciosas, Hospital L Sacco, Milán, ltalia
A. Cargnel
Affiliation:
Segundo Departamento de Enfermedades Infecciosas, Hospital L Sacco, Milán, ltalia
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Resumen

Proposito:

El propósito de este estudio era evaluar la prevalencia de trastornos del estado de ánimo actuales en pacientes seropositivos al VIH tratados con terapia farmacológica antirretrovírica combinada que incluía o no inhibidores de la proteasa.

Sujetos y métodos:

Se evaluó una muestra aleatoria de 90 sujetos que acudieron consecutivamente entre el 1 de febrero y el 31 de julio de 1998 a la unidad ambulatoria del Segundo Departamento de Enfermedades Infecciosas del Hospital “L. Sacco” en Milán por medio de la Entrevista Clínica Estructurada para el DSM-III-R (SCID) y la Escala de Autoevaluación de la Depresión de Zung (ZSDS).

Resultados:

Se clasificó a un 23,3% de sujetos en el estadio A de la CDC, a un 32,3% en el estadio B y a un 44,4% en el estadio C. Se encontro un diagnostico psiquiátrico del DSM-III-R de trastorno del estado de ánimo actual en 4,4% de la muestra seleccionada (distimia: 2,2%; trastorno adaptativo con estado de ánimo deprimido: 2,2%).

Conclusiones:

El efecto directo e indirecto de las nuevas terapias de combinación, los cambios epidemiológicos en los grupos sociales afectados por el VIH y las posibles modificaciones en la perceptión social de las personas con infección por VIH pueden explicar, al menos en parte, la disminución de la prevalencia de trastornos del estado de ánimo actuales observada en nuestro estudio comparado con las tasas de prevalencia comunicadas en la época anterior a la terapia antirretrovírica muy activa (TARMA).

Type
Artículo Original
Copyright
Copyright © European Psychiatric Association 2002

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References

Bibliografía

Brechtl, JRBreitbart, WGalietta, MKrivo, SRosenfeld, B.The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: Impact on medical, palliative cure and quality of life outcomes. J Pain Sympt Man 2001;21:41-51.CrossRefGoogle Scholar
Burack, JHBarrett, CStall, RDChesney, MAEkstrand, MLCoates, TJ.Depressive symptoms and CD4 lymphocyte decline among HIV-infected men. JAMA 1993;15:139-47.Google Scholar
Cavanaugh, S.Diagnosing depression in the hospitalised patient with chronic medical illness. J Clin Psychiatry 1984;45:13-6.Google Scholar
Chuang, HJason, JWPajurkova, EM, et al.Psychiatric morbidity in patients with HIV infection. Can J Psychiatry 1992;37:109-15.CrossRefGoogle ScholarPubMed
Dugan, WMcDonald, MVPassik, SDRosenfeld, BDTheobald, DEdgerton, S.Use of the Zung Self-Rating Depression Scale in cancer patients: feasibility as a screening tool. Psychooncol 1998;7:483-93.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Filippi, CGSze, GFarber, SJShahmanesh, MSelwyn, PA.Regression of HIV encephalopathy and basal ganglio signal intensity abnormality at MR imaging in patients with AIDS after the initiation of protease inhibitor therapy. Radiology 1998;206:491-8.CrossRefGoogle Scholar
Flexner, C.HIV-protease inhibitors. NEJM 1998;338:1281-92.CrossRefGoogle ScholarPubMed
Foudraine, NAHetelmans, RMWLange, JA.Cerebrospinal fluid HIV-1 RNA and drug concentration after treatment with lamivadine plus zidovudine or stavudine. Lancet 1998;351:1547-51.CrossRefGoogle ScholarPubMed
Gala, CPergami, PCatalan, JDurbano, FMusicco, MRiccio, M, et al.The psychosocial impact of HIV infection in gay men, drug users and heterosexuals. Br J Psychiatry 1993;163:651-9.CrossRefGoogle ScholarPubMed
Gisslen, MNorkrans, GSvennerholm, BHagbrg, L.HIV-1 RNA detectable with ultrasensitive quantitative polymerase chain reaction in plasma but not in cerebrospinal fluid during combination treatment with zidovudine, lamivudine and indinavir. AIDS 1998;12:114-6.Google Scholar
Hintz, SKuck, JPeterkin, JJVolk, DMZisook, S.Depression in the context of human immunodeficiency virus infection: implication for treatment. J Clin Psychiatry 1990;51:497-501.Google Scholar
Ickovics, JRHamburger, MEVlahov, DSchoenbaum, EESchuman, PBoland, RJ, et al.Mortality, CD4 cell count decline, and depressive symptoms among HlV-seropositive women. JAMA 2001;285:1466-74.CrossRefGoogle ScholarPubMed
Judd, FKCockram, AMKomiti, AMijich, AMHoy, JBell, R.Depressive symptoms reduced in individuals with HIV/AIDS treated with antiretroviral therapy: alongitudinal study. Aust N ZJ Psychiatry 2000;34:1015-21.CrossRefGoogle Scholar
Leserman, JPetito, JMPerkins, DOGolden, RNEvans, DL.Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virusinfectad men. Arch Gen Psychiatry 1997;54:279-85.CrossRefGoogle ScholarPubMed
Lipsitz, JDWilliams, JBWRabKin, JGRemien, RH.Psychopathology in mole and female intravenous drug users with and without HIV infection. Am J Psychiat 1994;151:1662-8.Google Scholar
Low-Beer, SChan, KYip, BWood, EMontaner, JSG.O’Shaughnessy, MVHogg, RS.Depressive symptoms decline among persons on HIV protease inhibitors. J Acq Imm Defic Syndr 2000;23:295-301.Google ScholarPubMed
Lyketsos, CGHoover, DRGuccione, MDew, MAWesch, JEBing, EGTreisman, GJ.Changes in depressive symptoms as AIDS develops. Am J Psychiat 1996;153:1430-7.Google ScholarPubMed
Maj, MJanssen, RStarace, FZaudig, MSatz, PSughondhabirom, BLuabeya, MARiedel, RNdetei, DCalil, HM.WHO Neuropsychiatric AIDS Study, cross-sectional phase. I. Study design and psychiatric findings. Arch Gen Psychiatry 1994;51:39-49.CrossRefGoogle ScholarPubMed
Maj, M.Depressive syndromes and symptoms in subjects with human immunodeficiency virus (HIV) infection. Br J Psychiatry 1996;168:117-22.Google Scholar
Perry, SJacobsberg, LBFishman, BFrances, ABobo, JJacobsberg, BK.Psychiatric diagnosis before serological testing for the human immunodeficiency virus. Am J Psychiatry 1990;147:89-93.Google ScholarPubMed
Power, CKong, PCrawford, T.Cerebral white matter changes in acquired immunodeficiency syndrome dementia: alterations in the blood-brain barrier. Ann Neurol 1993;34:339-50.CrossRefGoogle ScholarPubMed
Price, RBrew, BSidtis, J.The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex. Science 1988;239:586-92.CrossRefGoogle ScholarPubMed
Rabkin, JGFerrando, SJLin, SHSewell, MMcElhiney, M.Psychological effects of HAART: a 2-year study. Psychosom Med 2000;62:413-22.CrossRefGoogle ScholarPubMed
Rosemberger, PHBoernstein, RANasrallah, HAPara, MFWhitacre, CCFass, RJ, et al.Psychopathology in immunodeficiency virus infection: lifetime and current assessment. Compr Psychiatry 1993;34:150-8.CrossRefGoogle Scholar
Singh, NSquier, CSivek, CWagener, MHong Nguyen, MYu, VL.Determinants of compliance with antiretroviral therapy in patients with human immunadeficiency virus: prospective assessment with implications for enhancing compliance. AIDS Care 1996;8:261-9.Google Scholar
Spitzer, RWilliams, JBWGibbon, MFirst, MB.The structured clinical interview for DSMIII-R (SCID). I. History, rationale and description. Arch Gen Psychiatry 1992;49:624-9.CrossRefGoogle Scholar
Williams, JBWRabkin, JGRemien, RHGorman, JMEhrhardt, AA.Multidisciplinary baseline assessment of homosexual with and without human immunodeficiency virus infection. II. Standardised clinical assessment of current and lifetime psychopathology. Arch Gen Psychiatry 1991;48:124-30.CrossRefGoogle Scholar
Zung, WK.A self-rating depression scale. Arch Gen Psychiatry 1965;12:93-160.CrossRefGoogle ScholarPubMed