Aug. 18, 2000 -- HIV, the virus that causes AIDS, is difficult enough to manage under the best conditions. But add in aggravating factors, such as stress, and according to a new study, the medical situation gets even worse.
In the current issue of the American Journal of Psychiatry, the studyshows that men who are infected with HIV progress to AIDS more rapidly if they are experiencing stressful life events or don't feel that they have much support from people around them.
"We also found that cortisol, which is a hormone related to stress levels, and denial, when men said to themselves, 'No, this really isn't happening to me,' or 'If I just don't think about it, it will go away,' were also related to progression to AIDS from HIV infection," Jane Leserman, PhD, tells WebMD. Leserman is research associate professor of psychiatry at the University of North Carolina at Chapel Hill.
But the researchers' findings go beyond HIV men. "Other research has shown that these types of factors are also important in other diseases, such as cancer and heart disease. We need to start paying attention to how someone's state of mind may have an effect on disease," Leserman says.
Leserman and her colleagues studied more than 80 HIV-positive men in North Carolina. All of the men were self-reported homosexuals and did not have any symptoms of AIDS when they started the study, nor did they take any medications for HIV infection. They were seen every six months for up to seven-and-a-half years, and at each visit they were asked a number of questions to assess their mental state and life events. Blood samples also were taken at that time.
Men who reported less social support, more social stressors, who coped with being HIV-positive by denying that fact, and had higher cortisol levels, were more likely to develop AIDS than the other HIV-positive men.
Leserman says doctors often concentrate on treating the body and forget the disease's effect on the person's mind, or the effect of the person's mental state on his disease. "We might consider using cognitive therapy, stress management, and support groups in addition to medications in the treatment of HIV infection."
Marshall Forstein, MD, chair of the commission on AIDS of the American Psychiatric Association, tells WebMD, "What's great about this paper is it says that how we treat people mentally and help them manage their lives may be very important to the outcome of physical illness ... I often say that there's a reason for the neck: It's to connect the head to the body. It's folly to ignore how mental states can impact illness, and not just in HIV infection."
Forstein sees this study and others like it as support for coverage of mental health services as part of health insurance. "We must have parity in health care services," he says. "Our arbitrary and insane distinction between body and brain and our prejudice against mental disorders must be resolved."