CHICAGO, MARCH 3 -- AIDS patients are more likely to commit suicide than the general population, including victims of other terminal illnesses, a study has found.
Victims of acquired immune deficiency syndrome are doubly exposed to self-destructive impulses, first when they learn they have the disease, then when the disease begins to affect the central nervous system, researchers said.
The lesson of the study, published in Friday's Journal of the American Medical Association, is that physicians treating AIDS patients must be aware of the possibility of suicide, said one of the researchers, Dr. Peter M. Marzuk of Cornell University Medical College.
"Because of the risk for suicide, the presence of concomitant psychiatric syndromes, especially depression and delirium, should lead to early psychiatric intervention," he said.
The study found that the risk of suicide among men 20 to 59 years old with AIDS was 36 times greater than for other men in that age group and 66 times greater than for the general population. Other studies have shown that cancer victims are up to four times more likely than the general population to commit suicide.
The study was conducted among suicides in 1985 in New York City, where AIDS is the leading cause of death of men in their 30s. A total of 3,828 people had AIDS in the city then, of whom 12 were known to have killed themselves, all within nine months of being diagnosed and most within six months.
None showed signs of being in the advanced stages of the disease, but Marzuk said delirium and other psychiatric disorders can occur very early.
People who test positive for antibodies to the AIDS virus, even though they might not have the disease, could be potential suicides, Dr. Richard M. Glass wrote in an accompanying editorial.
While there are no major studies of suicides among those with positive tests, "a number of anecdotal reports have indicated that suicides have occurred as part of the psychological devastation that can result from the news . . . ," Glass wrote. "The enormity of this problem is indicated by estimates that approximately 1.5 million Americans have HIV antibodies."
A high proportion of AIDS suicides occurred in hospitals, the researchers said. "These suicides are sudden and impulsive, raising the possibility that delirium may have precipitated them," they said.