HIV associated psychiatric comorbidity among attendees at a tertiary hospital, North-Eastern Nigeria

Abstract

Background: There are a wide range of neuropsychiatric conditions associated with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). These mental disorders may be unrecognised yet their presence can significantly affect outcome. Aim: This study aimed to determine psychiatric comorbidity associated with HIV and AIDS. Setting: The HIV clinic of a tertiary hospital in North-Eastern Nigeria. Methods: A cross-sectional descriptive study consecutively recruiting 328 adult persons living with HIV. The Mini International Neuropsychiatric Interview and a sociodemographic questionnaire were administered to the participants. Results: Two-thirds of the respondents were females. The mean age (±s.d.) was 42 years (±11.24). Majority of the participants had World Health Organization stage 1 HIV disease. The prevalence of psychiatry comorbidity among our respondents was 82.9%. Social phobia was the leading disorder (69.8%). Others were mixed depression anxiety disorder (49.4%) and post-traumatic stress disorder (36.6%). Current psychosis was 27.7%, while major depressive disorder was 12.2%. Psychiatric comorbidity was significantly associated with male gender, religion, ethnicity, marital status and being unemployed with p < 0.01. Human immunodeficiency virus stage was related to panic disorder with p < 0.01, while viral load was significantly associated with depressive disorder with p = 0.001. Conclusion: Majority of our HIV patients attending the clinic have undetected psychiatric morbidity. Clinicians need to be aware of the features of major psychiatric disorders and refer appropriately for improved overall outcome. Contribution: This study contributes to the body of work on unrecognised psychiatric comorbidity in people living with HIV and AIDS, especially in North-Eastern Nigeria, identifying issues which are relevant to clinical practice and buttressing the need for integration of mental healthcare services into HIV treatment and prevention services.