Andrea Pergami

The psychological impact on staff of caring for people with serious diseases: The case of HIV infection and oncology

Psychological stress and work-related burnout in staff working with AIDS and with cancer patients were compared using a self-report method of assessment. Measures included the General Health Questionnaire (GHQ), Maslach Burnout Inventory (MBI), and the Social Adjustment Scale (SAS-M). More than 80% of those staff who were approached responded to the questionnaire, including 70 doctors and nurses working with people with AIDS and 41 doctors and nurses working in oncology. More than a third of staff had substantial levels of psychological morbidity, and about a fifth had significant levels of work-related stress. Factors associated with the presence of high levels of psychological morbidity and with abnormal levels of emotional exhaustion, depersonalization, and concerns about personal accomplishment were identified. Staff described the work situations with which they had difficulty dealing and some of the coping strategies they used. The findings confirm that staff working with people with cancer or AIDS experience psychological difficulties of the kind likely to respond to interventions aimed at improving their ability to cope with work-related stresses. The mental health services could play an important role in carrying out research in this field and in providing practical help to deal with staffs difficulties.

Women and HIV infection : Investigation of its psychosocial consequences

HIV infection is associated with substantial psychological and social morbidity, although there is a dearth of studies of women with the infection. In recent years, developed countries have reported an increase in the prevalence of HIV infection in women, a fact that makes it all the more important to address the study of their psychological and social status. The study is a controlled investigation of HIV seropositive (n = 49) and seronegative women (n = 43), including study of psychological status and history, social functioning and perceived supports, coping style, life events, and sexual difficulties. The results show that about a third of women were psychiatric cases, regardless of HIV status, although more than half of symptomatic women were psychiatric cases. Seropositive women were less likely to use instrumental social supports and more likely to use mental disengagement as ways of coping. Regarding perceived social supports, positive women had lower scores on social integration and guidance. Positive women were more likely to experience sexual difficulties and not to be in a relationship. Negative women reported more adverse life events in the last 6 months. Psychiatric morbidity was associated with poorer social adjustment and more adverse life events, but not with serostatus. HIV positive women and those at risk of HIV infection have substantial levels of psychological and social morbidity that require recognition by those involved in their care and provision of adequate mental health intervention.

Psychopathologic Features among Drug Addicts and Homosexuals with HIV Infection

Personal and familial psychopathological histories and information about early losses were collected and the results of the locus of control test and tests for psychological responses were determined for a series of ninety-two HIV-infected subjects (58 drug addicts; 26 homosexuals; 8 heterosexuals, partners of drug addicts). A higher percentage of drug addicts reported past histories of attempted suicide than the homosexuals. Early loss events were more frequent for homosexuals than for drug addicts. There was a higher psychopathological risk for asymptomatic HIV seropositivity in homosexuals, drug addicts who had attempted suicide, subjects that acknowledged that they have serious illness and subjects with external coping mechanisms rather than internal.

Factors associated with psychological help-seeking in HIV disease.

The study was aimed at evaluating the psychosocial and psychopathological characteristics of individuals with Human Immunodeficiency Virus (HIV) infection seeking psychological help compared with a sample not seeking help. Two hundred and seventy-one HIV seropositive (HIV+ve) subjects belonging to three transmission categories (90 gay men, 154 intravenous drug users and 27 heterosexuals) who were assessed at their first clinic appointment and offered access to psychological help were studied. Subsequently, it was found that 45 (17%) took advantage of the offer of psychological help, and attended a specialist clinic, while 226 (83%) did not seek help. Stepwise logistic regression analysis was used to establish the characteristics of subjects who received psychological help. Results showed that five factors identified at the time of first clinic appointment were significantly associated with seeking psychological help subsequently: (1) having a current DSM-III-R Axis I psychiatric diagnosis; (2) being single; (3) belief of being affected by a serious physical illness (negative correlation); (4) higher level of education; and (5) no past or current history of substance misuse. The implications of the findings are discussed.

Suicidal behaviour in HIV infection: a case-control study of deliberate self-harm in people with HIV infection

Abstract A group of 22 individuals with HIV infection who had made acts of self-harm were compared with a sex and age-matched control group of individuals without known HIV infection who had also being involved in acts of deliberate self-harm (DSH). Compared with all DSH individuals referred to the deliberate self-harm service during the same period. men were over-represented amongst HIV subjects. Compared with matched controls, HIV subjects were more likely to include gay/bisexual men, and not be employed. Individuals with HIV infection were more likely to be receiving outpatient psychiatric care at the time of DSH. and to have received it in the past A diagnosis of depression was given mom frequently to HIV subjects, while alcohol misuses was more often diagnosed in controls. Concerns about their physical health were prominent amongst HIV seropositives. Psychiatric follow-up was offered to HIV subjects more often than to controls. The results indicate that HIV disease is a potential contributing factor ...