title: Routine depression screening in an HIV clinic cohort identifies patients with complex psychiatric co-morbidities who show significant response to treatment.
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.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA, jschum@uab.edu.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schumacher
authors.forename: Cheryl
authors.initials: C
authors.lastname: McCullumsmith
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.forename: Paige E
authors.initials: PE
authors.lastname: Ingle-Pang
authors.forename: James L
authors.initials: JL
authors.lastname: Raper
authors.forename: James H
authors.initials: JH
authors.lastname: Willig
authors.forename: Zhiying
authors.initials: Z
authors.lastname: You
authors.forename: D Scott
authors.initials: DS
authors.lastname: Batey
authors.forename: Heidi
authors.initials: H
authors.lastname: Crane
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Lawrence
authors.forename: Charles
authors.initials: C
authors.lastname: Wright
authors.forename: Glenn
authors.initials: G
authors.lastname: Treisman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saag
mesh_terms: D000328:Adult; D000407:Alabama / Q000453:epidemiology; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012934:Social Isolation / Q000523:psychology*; D057545:Social Stigma; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014505:Urban Population; D019562:Viral Load