Publications [#150030] of Brian W Pence

Papers Published

1. BW Pence, WC Miller, K Whetten, JJ Eron, BN Gaynes, Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the Southeastern United States., Journal of acquired immune deficiency syndromes (1999), vol. 42 no. 3 (July, 2006), pp. 298-306 [doi] .
   (last updated on 2013/07/01)

   Abstract:
   BACKGROUND: Mood and anxiety disorders, particularly depression, and substance abuse (SA) commonly co-occur with HIV infection. Appropriate policy and program planning require accurate prevalence estimates. Yet most estimates are based on screening instruments, which are likely to overstate true prevalence. METHODS: Large academic medical center in Southeast. METHODS: A total of 1,125 patients, representing 80% of HIV-positive patients seen over a 2.5-year period, completed the Substance Abuse-Mental Illness Symptoms Screener, a brief screening instrument for probable mood, anxiety, and SA disorders. Separately, 148 participants in a validation study completed the Substance Abuse-Mental Illness Symptoms Screener and a reference standard diagnostic tool, the Structured Clinical Interview for DSM-IV. METHODS: Using the validation study sample, we developed logistic regression models to predict any Structured Clinical Interview for DSM-IV mood/anxiety disorder, any SA, and certain specific diagnoses. Explanatory variables included sociodemographic and clinical information and responses to Substance Abuse-Mental Illness Symptoms Screener questions. We applied coefficients from these models to the full clinic sample to obtain 12-month clinic-wide diagnosis prevalence estimates. RESULTS: We estimate that in the preceding year, 39% of clinic patients had a mood/anxiety diagnosis and 21% had an SA diagnosis, including 8% with both. Of patients with a mood/anxiety diagnosis, 76% had clinically relevant depression and 11% had posttraumatic stress disorder. CONCLUSIONS: The burden of psychiatric disorders in this mixed urban and rural clinic population in the southeastern United States is comparable to that reported from other HIV-positive populations and significantly exceeds general population estimates. Because psychiatric disorders have important implications for clinical management of HIV/AIDS, these results suggest the potential benefit of routine integration of mental health identification and treatment into HIV service sites.

   Keywords:
   Adult • Anxiety • CD4 Lymphocyte Count • Female • HIV Infections • Humans • Male • Middle Aged • Mood Disorders • Prevalence • Southeastern United States • Substance-Related Disorders • Viral Load • complications • complications* • epidemiology • epidemiology* • psychology