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The purpose of this study was to investigate the prescribing practices for the use of psychoactive medication in treating hospitalized patients with the acquired immunodeficiency syndrome (AIDS).The medical charts were studied for all patients admitted to a 20-bed AIDS inpatient ward from July through December 1986. One hundred and fifty-one patient-admissions comprised the sample. The average age of the patients was 37 years, and the average length of the hospital stay was 13 days. Retrospective chart review collected demographic data, length of stay, medical diagnosis, psychiatric history, and mental status on admission. Data on psychoactive drugs included the reasons for use, maximum daily dose and duration, and side effects ascribed to the drugs.Psychoactive drugs were used in 89% of the cases. Anxiolytics accounted for 49% of the psychoactive prescriptions, and hypnotics made up 43% of these prescriptions. The five most frequently used psychoactive drugs were benzodiazepines. The most frequent reasons for psychotropic prescriptions were insomnia (39%), psychologic distress (20%), and nausea (16%). The most frequently used anxiolytic and anti-psychotic medications were used in moderate dosage, while the most frequently used antidepressant was prescribed in low dosage.Hospitalized AIDS patients are highly likely to be prescribed a psychotropic medication, especially an anxiolytic or hypnotic. Anxiolytics are used for several purposes, including reduction of nausea associated with the use of antibiotics. Antidepressants and antipsychotics are rarely used. Practitioners must be sensitive to the presence of psychiatric conditions presenting as insomnia or disturbed mood so that the most specific and appropriate treatments can be used.

In answer to a questionnaire administered in 1961, 90% of responding physicians indicated a preference for not telling a cancer patient his diagnosis. To assess attitudinal changes, the same questionnaire was submitted to 699 university-hospital medical staff. Of 264 respondents, 97% indicated a preference for telling a cancer patient his diagnosis—a complete reversal of attitude. As in 1961, clinical experience was the major policy determinant, but the 1977 population emphasized the influence of medical school and hospital training. Our respondents indicated less likelihood that they would change their present policy or be swayed by research. Clinical experience was the determining factor in shaping two opposite policies. Physicians are still basing their policies on emotion-laden personal conviction rather than the outcome of properly designed scientific studies. ( JAMA 241:897-900, 1979)