Psychopatholgy, fundamental assumptions and CD-4 T lymphocyte counts in HIV-positive patients

Objective: We investigated whether psychopathology in HIV-positive patients was associated with more negative fundamental assumptions than in healthy controls. In addition; we explored whether psychopathology and negative fundamental assumptions in HIV-positive patients were associated with lower CD4 T-lymphocyte counts. Method: Self-rating questionnaires to assess depressive symptoms; posttraumatic stress symptoms; alcohol abuse; general psychopathology and fundamental assumptions; were completed by 123 HIV-positive patients and 84 uninfected clinic attendees at three primary health care clinics in the Western Cape; South Africa. CD4 T-lymphocyte counts were obtained from chart records. Results: HIV-positive patients reported more depressive and posttraumatic symptoms than uninfected individuals. However when controlling for socio-economic status; the number of traumatic events experienced and other potential confounds; no differences remained. Fundamental assumptions (FA) were mainly positive in both HIV-positive patients and controls and no correlations were found between fundamental assumptions; psychiatric symptoms and CD4 levels. However; in infected patients FA and psychopathology were negatively associated with all participants scoring in the positive range of the FA scale. Conclusion: The positive scores on the FA scale indicate that positive assumptions are related to less psychopathology. Longitudinal studies investigating the association between the valence of fundamental assumptions and HIV morbidity are needed

Emergency Care Provision for; and Psychological Distress in; Survivors of Domestic Violence

"Background : This study aimed (i) to ascertain the number of treatment referrals and information about protection orders given to survivors of domestic violence presenting for emergency trauma care; as reported at the one-month visit; (ii) to obtain a profile of violent incidents and injuries; and (iii) to assess self-esteem and posttraumatic and depressive symptomatology in the aftermath of injury.Methods : A survey of 62 participants presenting in the acute aftermath of domestic violence (as defined by the Domestic Violence Act of 1998) was conducted over 12 weeks at the Trauma and Resuscitation Unit of a Level One trauma centre in an urban public hospital in South Africa.1 Following informed consent; face-to-face structured interviews were conducted during admission and a month later. The following instruments were administered at baseline: a Demographic and Injury Questionnaire; the Beck Depression and Rosenberg Self-Esteem Inventories; and the Davidson Trauma Scale. A psychosocial questionnaire was administered at the one-month follow-up. Results : Fifty-eight per cent of the participants were female and 42 were male. Seventy-four per cent of the perpetrators were male. Ninety-five per cent of the participants said that no health professional had informed them about where or how they could find help. Although all were seriously injured; 76 of the participants said only the researcher had asked about their experience. Sixty-six per cent of the cases of domestic violence were related to intimate partner violence. Overall; subjects displayed high levels of depressive and post-traumatic stress symptomatology that had neither been treated nor adequately referred. Conclusion Even though domestic violence poses significant health threats and costs to the health system; it appears to be a neglected area of South African health care. Health professionals should at least be able to identify and intervene within the ""open window"" period when psychosocial opportunities are pivotal."