Comparision of the Frequency of Psychiatric Disorders in Patients with HTLV-1 Associated Myelopathy, Asymptomatic Carriers of Virus, and Healthy Control Group

Abstract

Background: Sexual transmission of human T-lymphotropic virus 1 (HTLV-1) has been widely reported in different populations, including Khurasan in the northeast of Iran. Objectives: The present study compared the frequency of psychiatric symptoms and disorders in patients with HTLV-1 associated myelopathy, asymptomatic carriers of the virus, and healthy control group. Patients and Methods: This cross-sectional study had three groups, including HTLV-1 infected patients who visited HTLV-1 Clinic of Qhaem Hospital of Mashhad, Iran (30 individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis [HAM/TSP] and 45 in the asymptomatic group) and 41 HTLV-1 seronegative individuals in the control group. All subjects were screened by SCL90 for psychiatric symptoms, as well as motor disability levels according to Osame’s motor disability score (OMDS). Subjects who scored higher than the cut-off point in each screening evaluation attended structured clinical interviews (SCID) based on the fourth edition of the diagnostic and statistical manual of mental disorders (DSM-IV-TR). The data were analyzed by using one-way analysis of variance (ANOVA), the spearman correlation test and chi-square test, and SPSS19 was used for statistical analysis (P < 0.05). Results: In general, 116 subjects were studied. The carrier and healthy groups were not significantly different in terms of psychiatric disorders. However, the frequencies of major depression (P = 0.011) and dysthymic disorders (P = 0.028) were higher in patients with myelopathy than healthy individuals. In addition, the frequency of the major depressive disorder was higher among patients with HAM/TSP than the HTLV-1 seronegative group (P = 0.002). The frequency distribution of major depression (P < 0.001) and generalized anxiety (P = 0.018) was observed with an increase in OMDS. Conclusions: Regarding the high frequency of psychiatric symptoms, especially in patients with myelopathy, designing suitable psychiatric interventions seems essential in such patients.