Major depression and generalized anxiety disorder among human T-lymphotropic virus types I- and II-infected former blood donors.

BACKGROUND: Other studies have reported high rates of depression and anxiety among human T-lymphotropic virus Type I (HTLV-I)-infected subjects and have even suggested that HTLV-I causes psychiatric disease. STUDY DESIGN AND METHODS: We interviewed HTLV-I, HTLV-II, and demographically similar HTLV-seronegative blood donors with the Mini-International Neuropsychiatric Interview. Prevalences of major depression and generalized anxiety disorder in each group were calculated and compared to published US population data. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) controlling for educational achievement, alcohol intake, and self-reported health status were calculated with multivariate logistic regression. RESULTS: Major depression was diagnosed in five (5.4%) of 93 HTLV-I-positive subjects (aOR, 2.19; 95% CI, 0.63-7.55) and 17 (6.6%) of 256 HTLV-II-positive subjects (aOR, 1.61; 95% CI, 0.66-3.927), compared to 12 (2.1%) of 585 HTLV-seronegative blood donors. The prevalence of major depression among infected subjects was comparable to the 6.7% prevalence in the US general population. Generalized anxiety disorder was diagnosed in five (5.4%) HTLV-I-positive subjects (OR, 2.32; 95% CI, 0.74-7.26) and 12 (4.7%) HTLV-II-positive subjects (OR, 1.65; 95% CI, 0.68-4.01), compared to 15 (2.6%) seronegative subjects and 3.1% in the US general population. CONCLUSION: Major depression and generalized anxiety disorder were not significantly more prevalent among HTLV-I- and HTLV-II-infected former blood donors after controlling for health status and other confounding variables. HTLV-seronegative blood donors had lower prevalences of these conditions than the US population, probably due to a "healthy blood donor effect."

Psychological distress in blood donors notified of HTLV-I/II infection. Retrovirus Epidemiology Donor Study.

BACKGROUND: Blood donations in the United States have been screened for antibody to human T-cell lymphotropic virus types I and II (HTLV-I/II) since November 1988. Although clinically diagnosed illness associated with HTLV-I/II remains relatively uncommon, blood donors notified of HTLV infection frequently report negative psychological and social effects following notification. STUDY DESIGN AND METHODS: To assess psychological outcomes, the General Well-Being Scale, a standardized 18-item questionnaire, was administered to 464 HTLV-I/II-positive donors and 91 sex partners at five blood centers in the United States following notification of HTLV-I/II infection. The questionnaire was also given to 735 HTLV-I/II-negative donors. RESULTS: Scores for donors seropositive for HTLV-I and HTLV-II showed significantly more psychological distress than did scores for seronegative donors (p < 0.0005) or a large national sample (p < 0.05). Both HTLV-I (p = 0.02) and HTLV-II (p = 0.01) seropositivity remained significant predictors of lower overall well-being scores after analysis controlling for race, age, gender, education, income, donation type, time since notification, self-reported health status, and intravenous drug use. Variables that predicted higher overall scores were negative HTLV status, older age, higher income, better health, fewer sick days, and fewer work limitations due to health problems. CONCLUSION: Increased psychological distress may be related to notification of HTLV infection among blood donors in the United States.