Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study

Seth Himelhoch, Joshua S. Josephs, Geetanjali Chander, Philip (Todd) Korthuis, Kelly A. Gebo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)538-545
Number of pages8
JournalGeneral Hospital Psychiatry
Volume31
Issue number6
DOIs
StatePublished - Nov 2009

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Mental Health Services
Ambulatory Care
HIV
Highly Active Antiretroviral Therapy
Hispanic Americans
Psychiatry
Primary Health Care
Logistic Models
Drug Users
Mental Health
Odds Ratio
Demography
Research

Keywords

  • HIV-infected patients
  • Outpatient mental health services
  • Psychotropic medications

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Use of outpatient mental health services and psychotropic medications among HIV-infected patients in a multisite, multistate study. / Himelhoch, Seth; Josephs, Joshua S.; Chander, Geetanjali; Korthuis, Philip (Todd); Gebo, Kelly A.

In: General Hospital Psychiatry, Vol. 31, No. 6, 11.2009, p. 538-545.

Research output: Contribution to journalArticle

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abstract = "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.",
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