Does Screening HIV-Positive Individuals in Uganda for Major Depressive Disorder Improve Case Detection Rates and Antidepressant Prescription?
Does Screening HIV-Positive Individuals in Uganda for Major Depressive Disorder Improve Case Detection Rates and Antidepressant Prescription?
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DOI：
10.1007/s10461-012-0383-y
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发表时间：
2013-10-01
影响因子：
4.4
通讯作者：
Joska, John
中科院分区：
文献类型：
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作者：
Akena, Dickens;Stein, Dan J.;Joska, John
艾滋病毒阳性者的严重抑郁症往往得不到诊断，治疗也很差。抑郁症筛查对病例检测和抗抑郁药处方率的影响尚不清楚。我们评估了368名参与者的重度抑郁症，并向临床医生提供了结果。四周后，我们从抑郁症患者的图表中提取信息，以确定他们是否接受了抗抑郁药。我们还随机抽取了368名未筛查患者的病历，以确定临床医生是否诊断并处方了抗抑郁药物治疗，筛查组中17.9%的患者被确定为重度抑郁障碍，而未筛查组中2.1%的患者被确定为重度抑郁障碍[OR = 9.65，CI =（4.54-20.50）]。筛选的个体接受抗抑郁药的可能性是对照组的7.8倍（95%CI = 3.04-20.24）。临床医生在艾滋病毒环境中对重度抑郁症的识别仍然很差。然而，常规筛查可以提高病例检出率和接受抗抑郁药的患者比例。
Major depressive disorder in HIV-positive persons is often not diagnosed, and poorly treated. The effect of depression screening on case detection, and rates of antidepressant prescription is unknown.We assessed 368 participants for major depressive disorder, and provided clinicians with the results. Four weeks later, we abstracted information from the charts of the depressed patients to ascertain if they received antidepressants. We also randomly sampled the charts of 368 non-screened patients, to ascertain whether clinicians had diagnosed and prescribed antidepressant treatment.Major depressive disorder was identified in 17.9 % of the screened group, and in 2.1 % of the non-screened group [OR = 9.65, CI = (4.54-20.50)]. The screened individuals were 7.8 times more likely to receive antidepressants (95 % CI = 3.04-20.24). Identification of major depressive disorder by clinicians in HIV settings remains poor. However, routine screening can improve case detection rates and the proportion of patients receiving antidepressants.