Prevalence of pyschiatric disorders in HIV positive patients at Chilenje Clinic in Lusaka Zambia

Abstract

Psychiatric disorders occur frequently in people living with HIV. Most of them go undiagnosed and therefore untreated, despite the negative consequences they have on HIV spread, progression and management. The aim of the study was to determine the prevalence of psychiatric disorders in HIV positive patients, as well as to determine demographic and clinical factors that are associated with these disorders. The study was cross sectional. One hundred and eighty five HIV positive adults attending the HIV clinic, at Chilenje clinic in Lusaka, Zambia were recruited. The Mini International Neuropsychiatric Interview (MINI) and The International HIV Dementia Scale were used to assess these disorders. The overall prevalence of psychiatric/neuropsychiatric disorders was 48.1%. The most frequent diagnosis was probable HIV Associated dementia, accounting for 30.8% (n=57). The prevalence of alcohol dependence/abuse, depression, any anxiety disorder and mania/hypomania was 9.2% (n=17), 7% (n=13), 6.5% (n=12) and 2.7% (n=5) respectively. Psychotic symptoms were present in 9.2% (n=17) of which 3.8% (n=7) were psychotic symptoms likely to be attributed to ARVS, 2.7% (n=5) was mood disorder with psychotic symptoms, and 2.7% (n=5) were primary psychotic symptoms. Co-morbidity was present in 20(22.47%) accounted for mostly by either depression with anxiety disorders or depression with probable HIV associated dementia. Those with alcohol dependence/abuse were more likely to be males ( 2=16.718, p=0.001) and most likely to practice unsafe sex. Patients with depression were more likely to be separated or widowed and unemployed or students ( 2=7.177, p=0.046). Panic disorders were associated with being a student or unemployed ( 2 =7.794, p= 0.035) whilst patients with mania/hypomania were likely to be younger ( 2 2.048, t=0.042). The rate of psychiatric disorders and probable HIV associated dementia in HIV positive patients in Zambia is high. Most of them go unnoticed and untreated despite some of them being associated with behaviors likely to fuel the spread of HIV. Therefore, the fight against this pandemic will be strengthened by the integration of mental health care into the routine management of HIV infected patients.