Anxiety, depression and impairment of quality of life in HIV-infected outpatients

The aim of this study was to investigate the prevalence of anxiety, depression and health-related quality of life in patients with HIV infection, and to examine their dependency on biosocial parameters relating to HIV. Prospective clinical, virological and immunological data were obtained in a cross-sectional study within the Swiss HIV Cohort Study. Four self-reported questionnaires were used in 397 HIV-infected individuals. Psychometric scores are shown test scores were adjusted onto a scale of 0-100; values below 50 (cutoff) were associated with absence of the assessed test quality; except for the VAS where the score directly correlates with the scale (cutoff < 75). The prevalence of anxiety was 21% according to the State-Trait Anxiety Inventory and 57% according to the Hospital Anxiety and Depression Scale. Depression was measured by the latter scale at 61%. Half the population scored < 75 on a visual analog scale (VAS). HIV-MOS summary scores showed 38% and 58% of individuals to be affected in their physical and mental functioning (PHS + MHS), respectively. Almost all scores were significantly worse for intravenous drug users, compared with other transmission groups. People in employment, with a higher education or with higher CD4 count tended to score better, whereas those having been hospitalized within the last six months, infected for a longer time, with higher viral load or loss of weight scored significantly worse. A multivariate analysis showed higher education, being in employment, low viral load, and shorter HIV disease duration to be associated with better scores. Anxiety, depression and impaired quality of life are frequent in HIV-infected individuals, including those patients with an optimal response to therapy. This study highlights the importance of mental health assessment and the need for coping strategies for HIV-infected patients.