Mental health disparities in people living with human immunodeficiency virus: A cross-sectional study on physician-patient concordance and treatment regimens
Mental health disparities in people living with human immunodeficiency virus: A cross-sectional study on physician-patient concordance and treatment regimens作者机构：The Second Infectious Disease Department Hangzhou Xixi Hospital Zhejiang University School of Medicine Hangzhou Zhejiang China Department of Clinical Epidemiology and Evidence-based Medicine Shanxi Bethune Hospital Shanxi Academy of Medical Sciences Tongji Shanxi Hospital Third Hospital of Shanxi Medical University Taiyuan Shanxi China Department of Neurology The First Affiliated Hospital of Kunming Medical University Kunming Yunnan China Department of Psychiatry The First Affiliated Hospital of Kunming Medical University Kunming Yunnan China Department of Neurology Affiliated Hospital of Yunnan University Kunming Yunnan China Neurology Department Qian’an People’s Hospital Qian’an Hebei China Department of Neurology Xuanwu Hospital Capital Medical University Beijing China
出 版 物：《中华医学杂志(英文版)》 (Chinese Medical Journal)
年 卷 期：2024年第137卷第18期
页 面：2024 Aug 21页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学]
基 金：This work is supported by grants from the National Natural Science Foundation of China(No. 82160272) Yunnan Science and Technology Leading Talents Project, Young and Middle-aged Academic and Technical Leaders Reserve Talents Project(No. 202405AC350046) the Research Program of Yunnan Science and Technology Department(No. 202101AT070151) the Project of Technology Innovation Team of Kunming Medical University(No. CXTD202104 to X.L)
主 题：Human immunodeficiency virus Depression Anxiety Mental health Overestimation Underestimation
摘 要：Background: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) can profoundly affect the mental health of the people living with HIV (PLWH), with higher rates of anxiety, depression, and sleep disturbances. The disparities in neuropsychological problems evaluated by physicians and self-assessed by patients are still ***: A total of 5000 PLWH and 500 physicians from 167 hospitals were enrolled in this cross-sectional study from September 2022 to February 2023. 4-Item Patient Health Questionnaire (PHQ-4) was used for the evaluation of depressive issues and anxiety issues by PLWH. Each physician assessed 10 PLWH under their care for the presence of depressive or anxiety issues. The primary outcomes of this study are the concordance rates on the depressive issues and anxiety issues evaluation between physicians and PLWH. The Cohen’s kappa test was used to assess the agreement between physicians and ***: The concordance rate for the evaluation of depressive issues is 73.84% (95% confidence interval [CI]: 72.60-75.04%), and it is significantly different from the expected rate of 80% (P 0.001). Similarly, the concordance rate for the evaluation of anxiety issues is 71.74% (95% CI: 70.47-72.97%), which is significantly different from the expected rate of 80% as per the null hypothesis (P 0.001). The overestimation rate by physicians on depressive issues is 12.20% (95% CI: 11.32-13.14%), and for anxiety issues is 12.76% (95% CI: 11.86-13.71%). The mismatch rate for depressive issues is 26.16% (95% CI: 24.96-27.40%), and for anxiety issues is 28.26% (95% CI: 27.02-29.53%). The underestimation rate by physicians on depressive issues is 13.96% (95% CI: 13.03-14.95%), and for anxiety issues is 15.50% (95% CI: 14.52-16.53%). For the treatment regiments, PLWH sustained on innovative treatment regimen (IR) related to a lower prevalence of depressive issues (odds ratio [OR] = 0.71, 95% CI: 0.59-0.87,P = 0.003) and a lower prevalence o
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