Research in Medicine

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Background: CD4 count is the most important indicator of the degree of immune deficiency in HIV-positive patients. The goal of this research was to study the relationship between CD4 count and psychological disorders in these patients. Materials and methods: In this cross-sectional study, subjects were studied from June 2004 for one year in Sina hospital in Kermanshah. HIV infection was confirmed with positive double ELISA and Western Blot, CD4 counts by flow-cytometery. SCL-90-R questionnaire was used for selection of patients. In the second stage diagnostic symptom checklist based on DSM-IV criteria was used for patients with unconfirmed diagnosis of psychological disorders. All data were then analyzed. Results: From 59 studied patients, 58 patients were males all being addicts with prison records. Mean age of patients was 34.26±7.4, (range 23 to 50), years. Mean CD4 count was 312±216 per micro liter. The incidence of psychological disorders was 62.7% multiple disorders 22%, mood disorder %22, anxiety disorder %8.5, psychotic disorder 5.1%, cognitive disorder 3.4%, and personality disorder 1.7%. The least CD4 count was found in single cognitive disorder (129cells/ul). There was a significant statistical relationship between cognitive disorder, (apart from it combination with other disorders), and CD4 count of lower than 200 per micro liter (p=0.021) and CD4 percent lower than 15 (p=0.032). Also, relation between single anxiety disorder and CD4 count of lower than 200 per micro liter was significant, (p=0.033). In addition, there was a significant relationship between pneumonia syndrome and mood disorder (p=0.009), and between soft tissue infection and psychotic disorder (p=0.017). Prison settlement of over 60 months was related to anxiety disorder (p=0.045). Conclusion: In this research psychiatric disorder incidence was higher than other studies that could be due to the high rate of addiction and imprisonment. Relation between CD4 count with cognitive and anxiety disorders indicated that with the progression of HIV infection, there is an increase in the occurrence psychological disorders with social problems having additional adverse effects on the psychological status.

Keywords: HIV/AIDS, Psychological disorders, CD4 count, Kermanshah.

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