AIDS and Behavior

, Volume 17, Issue 8, pp 2781–2791 | Cite as

Routine Depression Screening in an HIV Clinic Cohort Identifies Patients with Complex Psychiatric Co-morbidities Who Show Significant Response to Treatment

  • Joseph E. Schumacher
  • Cheryl McCullumsmith
  • Michael J. Mugavero
  • Paige E. Ingle-Pang
  • James L. Raper
  • James H. Willig
  • Zhiying You
  • D. Scott Batey
  • Heidi Crane
  • Sarah T. Lawrence
  • Charles Wright
  • Glenn Treisman
  • Michael S. Saag
Original Paper

Abstract

This study described characteristics, psychiatric diagnoses and response to treatment among patients in an outpatient HIV clinic who screened positive for depression. Depressed (25 %) were less likely to have private insurance, less likely to have suppressed HIV viral loads, had more anxiety symptoms, and were more likely to report current substance abuse than not depressed. Among depressed, 81.2 % met diagnostic criteria for a depressive disorder; 78 % for an anxiety disorder; 61 % for a substance use disorder; and 30 % for co-morbid anxiety, depression, and substance use disorders. Depressed received significantly more treatment for depression and less HIV primary care than not depressed patients. PHQ-9 total depression scores decreased by 0.63 from baseline to 6-month follow-up for every additional attended depression treatment visit. HIV clinics can routinely screen and treat depressive symptoms, but should consider accurate psychiatric diagnosis as well as co-occurring mental disorders.

Keywords

Depression HIV Clinic Treatment Cohort 

Resumen

Este estudio describe las características, diagnósticos psiquiátricos y respuesta al tratamiento entre pacientes externos de una clínica de VIH (virus de inmunodeficiencia humana) que fueron positivos a un escrutinio de depresión. Los pacientes deprimidos (25 %) fueron menos probables de tener seguro privado, menos probables de tener cargas virales de VIH suprimidas, estar más ansiosos y reportar más abuso de substancias que los no deprimidos. Entre los deprimidos, 81.2 % cumplieron los criterios para un desorden depresivo, 78 % para un desorden de ansiedad; 61 % para un desorden de abuso de substancias y 30 % para una ansiedad comorbida, depresión y abuso de substancias. Los pacientes deprimidos recibieron significativamente más tratamiento para depresión y menos cuidado primario para VIH que los no deprimidos. El puntaje total para depresión usando la escala de PHQ-9 disminuyó 0.63 del puntaje basal a los 6 meses de seguimiento por cada visita para tratamiento de depresión adicional. Las clínicas de VIH pueden rutinariamente escrutinizar y tratar síntomas de depresión, pero deberían considerar los diagnósticos psiquiátricos así como la co-ocurrencia de enfermedades mentales.

Notes

Acknowledgments

This research was sponsored by a Grant from Boehringer-Ingelheim. The authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE) and were fully responsible for all aspects of manuscript development.

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Joseph E. Schumacher
    • 1
  • Cheryl McCullumsmith
    • 2
  • Michael J. Mugavero
    • 3
  • Paige E. Ingle-Pang
    • 3
  • James L. Raper
    • 3
  • James H. Willig
    • 3
  • Zhiying You
    • 1
  • D. Scott Batey
    • 4
  • Heidi Crane
    • 5
  • Sarah T. Lawrence
    • 4
  • Charles Wright
    • 3
  • Glenn Treisman
    • 6
  • Michael S. Saag
    • 3
  1. 1.Division of Preventive Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Division of Consultation & Liaison, Department of PsychiatryUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Division of Infectious Diseases, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.Behavioral Science Core, Center for AIDS ResearchUniversity of Alabama at BirminghamBirminghamUSA
  5. 5.Department of MedicineUniversity of WashingtonSeattleUSA
  6. 6.Department of PsychiatryJohns Hopkins UniversityBaltimoreUSA

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