Document Detail


Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study.
MedLine Citation:
PMID:  19892212     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although co-occurring psychiatric disorders are highly prevalent among those with HIV, little is known about the use of outpatient mental health services (MHS) and psychotropic medication in the highly active antiretroviral therapy (HAART) era.
METHODS: During 2003, 951 patients were interviewed at 14 sites in the HIV Research Network. Patients were questioned about use of MHS and psychotropic medications. Logistic regression was used to identify socio-demographic and clinical factors associated with MHS and psychotropic medication utilization.
RESULTS: The sample characteristics were as follows: 68% male, 52% black, 14% Hispanic, median age 46 years (range 20-85), 69% were on HAART. Approximately 34% reported at least one MHS within 6 months and 37% reported use of psychotropic medication for a mental health condition. In multivariate logistic regression, MHS was greater among disabled patients [adjusted odds ratio 2.39 (95% CI 1.53-3.72)], current [2.26 (1.53-3.35)] and former drug users [1.84 (1.24-2.73)], and those with more than seven primary care visits in the past 6 months. Blacks [0.61 (0.41-0.92)] were significantly less likely to use MHS compared to whites. Similarly, usage of psychotropic medications was greater among disabled patients [1.79 (1.14-2.82)], women [1.66 (1.13-2.43)], )] and those with more than seven primary care visits. Blacks [0.37 (0.24-0.58])] and Hispanics [0.39 (0.22-0.72)] were less likely to use a psychotropic medication. HAART utilization was not associated with MHS or psychiatric medication use.
CONCLUSIONS: In the HAART era, self-reported rates of mental health service and psychotropic medication utilization are high. Blacks continue to report lower use of MHS and psychotropic medication compared to whites.
Authors:
Seth Himelhoch; Joshua S Josephs; Geetanjali Chander; P Todd Korthuis; Kelly A Gebo;
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2009-08-27
Journal Detail:
Title:  General hospital psychiatry     Volume:  31     ISSN:  1873-7714     ISO Abbreviation:  Gen Hosp Psychiatry     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-11-06     Completed Date:  2010-01-19     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  7905527     Medline TA:  Gen Hosp Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  538-45     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA. shimelho@psych.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antiretroviral Therapy, Highly Active
Community Mental Health Services / utilization*
Comorbidity
Drug Utilization / statistics & numerical data
Female
HIV Infections / drug therapy*,  epidemiology*,  psychology
Humans
Male
Mental Disorders / drug therapy*,  epidemiology*,  psychology
Middle Aged
Psychotropic Drugs / therapeutic use*
United States
Utilization Review / statistics & numerical data
Young Adult
Grant Support
ID/Acronym/Agency:
290-01-012//PHS HHS; K23 DA019809-03/DA/NIDA NIH HHS; K23 DA019820-04/DA/NIDA NIH HHS; K23- DA019820/DA/NIDA NIH HHS; K23-DA019809/DA/NIDA NIH HHS; R01 AG026250/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Psychotropic Drugs
Investigator
Investigator/Affiliation:
Howard Edelstein / ; Silver Sisneros / ; Richard Rutstein / ; Roberto Corales / ; James Hellinger / ; Sara Allen / ; Norman Markowitz / ; Kelly Gebo / ; George Siberry / ; Allison Agwu / ; Robert Beil / ; Lawrence Hanau / ; Patrick Nemechek / ; Todd Korthuis / ; Philip Keiser / ; Aditya Gaur / ; Victoria Sharp / ; Chararut Somboonwit / ; Stephen Spector / ; W Christopher Mathews / ; Jonathan Cohn /
Comments/Corrections

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