April 1996

Personality Disorders Predict Onset of Axis I Disorders and Impaired Functioning Among Homosexual Men With and at Risk of HIV Infection

Author Affiliations

From the Department of Psychiatry, Columbia University, and the New York State Psychiatric Institute (Drs Johnson, Williams, Goetz, Rabkin, Lipsitz, and Gorman) and the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York City (Dr Remien).

Arch Gen Psychiatry. 1996;53(4):350-357. doi:10.1001/archpsyc.1996.01830040086013

Background:  A longitudinal study was conducted to investigate whether personality disorders (PDs) increase risk for the development of future Axis I disorders and serious functional impairment among human immunodeficiency virus (HIV)—seropositive and HIV-seronegative homosexual men.

Method:  Baseline assessments of PDs, Axis I disorders and symptoms, and Global Assessments of Functioning were conducted with a community sample of 107 (66 HIV-positive and 41 HIV-negative) homosexual men partici-pating in a longitudinal study with semiannual interviews over 3 years.

Results:  Logistic regression analysis indicated that PDs predicted onset of subsequent Axis I disorders after controlling for both HIV status and lifetime Axis I history (adjusted odds ratio, 4.31; P=.01; 95% confidence interval, 1.39 to 13.32). Of the 21 participants with PDs, 16 (76%) were subsequently diagnosed with Axis I disorders on at least one occasion. By contrast, only 36 (42%) of the 86 participants without PDs were subsequently diagnosed with Axis I disorders. Further, 33% of the participants with PDs, in comparison with only 8% of those without PDs, were assigned Global Assessments of Functioning scores of 50 or lower, indicating serious impairment during the postbaseline study period (adjusted odds ratio, 5.70; P<.005; 95% confidence interval, 1.66 to 19.53).

Conclusion:  Personality disorders may contribute to increased risk for onset of Axis I disorders and serious impairment among homosexual men regardless of HIV serologic status.