Assessment of Psychiatric Symptoms Using SCL-90-R among HIV/AIDS Individuals in Razavi Khorasan Province, Iran

Dear Editor, HIV infection, the same as other chronic diseases, is associated with psychiatric symptoms. 1 A profound psychological distress is made after the diagnosis of infection, and several psychiatric disorders including AIDS phobia, bereavement and grief, anxiety and depression were shown as a reaction to the infection. 2 Associating the infection to the stigmatized and illegal behaviors by the family, friends, and others, especially in the developing countries, as well as the nature of the infection that is frustrating and incurable, both affect the patients enormously. 3 A lack in investigations on the psychiatric symptomatology of HIV infection in our country, which surely affects the pa-tient's compliance and management process, convinced us to assess the frequency and severity of psychiatric symptoms in those living with HIV in Razavi Khorasan Province, northeast of Iran. From the 320 cases of HIV infection, documented in the Health Center of Razavi Khorasan Province, Mashhad, Iran, up to 2006, all above 15 years old with an ongoing management (n=61), were included in the study. Others were not accessible because of death, migration and non-cooperation. Demographic characteristics, clinical and laboratory findings were defined according to their management files. Symptom Checklist 90-Revised (SCL-90-R) with sensitivity and specificity of 80.9% and 92.7% in a national study, 4 was filled out by a clinical psychologist. The 90 items in the questionnaire were scored on a five-point Likert scale (0-4), indicating the rate of occurrence of the symptom during the time reference. The response rate was 82% (50/61). Respondents were 21-51 (35.9 ± 7.1) years old, 90% male, 74% married at least once, 52% unemployed, 46% with utmost 5 years education, 80% IUDs, 84% with a history of imprisonment, 30% AIDS patients, 66% HCV-Ab positive, and 12% HBs-Ag positive. The checklist-derived scores were: Overall score 145. Symptom Distress Index, the average score of the items scored above zero) 2.3±0.53 (1.2-3.4). The GSI is suggested to be the best single indicator of the current level of the disorder. Those with a GSI above 1 were considered to have psychiatric symptoms (79.6%). With the cutoff point of 0.7, defined in another study in Iran, 8 symptom prevalence was 85.7%. Severity of psychiatric symptoms according to the GSI index was low (1-1.99) in 46.9%, moderate (2-2.99) in 30.6%, and severe (≥3) in 2% of cases. Another study in Iran showed the frequency of psychiatric symptoms as high as 93.2%, among HIV-infected individuals …