Use of psychotropic medications among HIV-infected patients in the United States.
OBJECTIVE
This study describes the prevalence and pattern of use of psychotropic medications by HIV-positive patients receiving medical care in the United States and the search for possible predictors of use.


METHODS
The HIV Cost and Services Utilization Study database was analyzed. From the estimated 231,400 HIV-positive patients in medical care in the contiguous United States, a probability sample of 2,864 adults who had paid at least one visit to their medical provider in early 1996 was selected. A representative group of 1,561 received the long form of the Composite International Diagnostic Interview and a questionnaire on psychotropic medications used during the previous 6 months; 1,489 patients (95.4%) completed the assessments.


RESULTS
An estimated 27.2% of HIV-positive patients took psychotropic medications in 1996. Antidepressants were the most commonly prescribed drug class (20.9% of patients), followed by anxiolytics (16.7%), antipsychotics (4.7%), and psychostimulants (3.0%). Among patients with major depression or dysthymia, 43.2% reported receiving antidepressants, and 34.3% reported receiving anxiolytics. Psychiatric comorbidity was associated with greater use of psychotropics. Use of psychotropics in general, and antidepressants in particular, was significantly lower among African Americans than whites or Hispanics. Among patients with mood disorders, 61.0% of whites, 51.4% of African Americans, and 66.7% of Hispanics reported use of antidepressant medications or some type of psychosocial intervention.


CONCLUSIONS
Psychotropics were commonly used by HIV-positive patients in medical care. About half of the patients suffering from depressive disorders did not receive antidepressants. Psychotropic drug use was lower among African Americans than other ethnic groups.
Vitiello
Benedetto
B
Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-9633, USA. bvitiell@nih.gov
Burnam
M Audrey
MA
Bing
Eric G
EG
Beckman
Robin
R
Shapiro
Martin F
MF
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D015897:Comorbidity; D003695:Delivery of Health Care / Q000592:standards; D003866:Depressive Disorder / Q000188:drug therapy; D004363:Drug Utilization; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D011619:Psychotropic Drugs