Premium
Simple and practical screening approach to identify HIV ‐infected individuals with depression or at risk of developing depression
Author(s) -
Rodkjaer L,
Gabel C,
Laursen T,
Slot M,
Leutscher P,
Christensen N,
Holmskov J,
Sodemann M
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12381
Subject(s) - depression (economics) , medicine , mental health , beck depression inventory , psychiatry , patient health questionnaire , history of depression , human immunodeficiency virus (hiv) , depressive symptoms , clinical psychology , family medicine , anxiety , economics , macroeconomics
Objectives Studies have shown that depression and other mental illnesses are under‐diagnosed among HIV ‐infected individuals. The aim of this study was to evaluate the use of mental health history and questionnaire‐based screening instruments to identify HIV ‐infected individuals at risk of depression. Methods The Beck Depression Inventory II ( BDI ‐ II ) was used to assess the prevalence and severity of depressive symptoms among HIV ‐infected individuals attending two out‐patient clinics in Denmark. HIV ‐infected individuals with a BDI ‐ II score ≥ 20 were offered a clinical evaluation by a consultant psychiatrist. The BDI ‐ II score was compared to the outcome of mental health history review, and to results obtained using the European AIDS Clinical Society ( EACS ) two‐item depression screening tool. Results A total of 501 HIV ‐infected individuals were included in the study. Symptoms of moderate/major depression ( BDI ‐ II score ≥ 20) were observed in 111 patients (22%); 65 of these patients consulted a psychiatrist, of whom 71% were diagnosed with a co‐existing disorder. The BDI‐II score was compared to the outcome of a mental health history review, and to results obtained using the European AIDS Clinical Society (EACS) two‐item depression screening tool. The two questions showed a sensitivity and specificity of 95% and 68%, respectively, for diagnosis of current depression or risk of depression. A previous psychiatric history and substance abuse were independently associated with an increased risk of depression. Conclusions We suggest that the mental health of HIV ‐infected individuals should be reviewed and a “risk‐flag” three‐step approach should be used (1) to screen routinely with the two verbal questions suggested by the EACS , (2) to identify whether there is a risk of depression and then screen with the BDI ‐ II , and (3) to identify whether there is still a risk and then perform a full evaluation and obtain an accurate psychiatric diagnosis by a psychiatrist.