Bipolar disorder common in HIV patients

By Mark Cowen, Senior medwireNews Reporter

Patients with HIV are significantly more likely to have bipolar disorder than the general population, researchers report.

In a study of 200 HIV-infected patients aged between 18 and 65 years, the team found that 15% tested positive for bipolar disorder on the Mood Disorder Questionnaire (MDQ).

The MDQ is a commonly used self-report screening instrument for bipolar disorder containing 13 yes/no symptom items, and assesses the frequency and psychosocial impact of such symptoms. A positive screen for bipolar disorder requires that seven or more positive symptoms are present, with clustering within the same period, and causing moderate to severe psychosocial problems.

The researchers found no significant differences between the 30 MDQ-positive and 170 MDQ-negative patients regarding gender, age, years since HIV diagnosis, self-reported sexual orientation, and prevalence of sex and condom use with regular partners.

However, MDQ-positive patients were significantly more likely than MDQ-negative patients to have had sex with non-regular partners (90 vs 69%), infrequent condom use with nonregular sex partners (81 vs 53%), and sex with commercial partners (50 vs 14%).

MDQ-positive patients were also more likely than MDQ-negative patients to be unemployed (47 vs 27%) or retired (27 vs 11%), but were less likely to have never married (30 vs 50%).

After HIV diagnosis, sexual behavior decreased dramatically among all patients, although such decreases were greater among MDQ-positive than MDQ-negative patients.

They researchers explain that the prevalence of bipolar disorder among HIV patients in this study is around 50% higher than that in similar low-income patients without HIV attending urban clinics, and even higher than the general population rate of 2.6%.

Souza et al conclude in the Journal of Affective Disorders: "The high prevalence of MDQ-positive patients suggests that the pattern of sexual behavior among MDQ-positive patients may contribute to HIV infection."

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