The majority of HIV-positive American patients are not asked about their mental health by their HIV doctor, according to American research presented as a poster at the Second International AIDS Society Conference on HIV Pathogenesis and Treatment in Paris.
The study involved interviews with 153 US HIV specialists and 253 of their patients. Although over 80% of doctors said that their patients’ mental health was a ‘high priority’ when making decisions about treatment, 62% of patients said that they had never been asked questions about their mental health by their doctor.
Mental health problems were widely reported by patients to the investigators from the International Association of Physicians in AIDS Care (IAPAC), with 72% saying that they had experienced depression, 65% anxiety, 48% insomnia, 43% lethargy, 41% irritability, and 40% poor concentration and mood swings.
Doctors appeared willing to prescribe medication to help treat mental health disorders, with 63% reporting the prescription of antidepressants to their HIV-positive patients. However, although almost 75% of physicians said that they knew anti-HIV drugs could cause mental health problems, only 56% would recommend that their patients change their medication because of them.
The IAPAC investigators conclude that better physician awareness of their patients’ mental health could lead to better clinical management, and recommend that doctors refer their HIV patients experiencing mental health problems for specialist counseling and care to help alleviate short-term mental health problems which could be a consequence of HAART. However, they recommend that doctors should be prepared to ‘strategically prescribe’ in order to avoid psychiatric problems in their patients.
Zuniga JM et al. Managing psychiatric manifestations of HIV infection. Antiretroviral Therapy 8 (suppl.1), abstract 746, 391, 2003.