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新发 HIV 诊断前后 1 年和 2 年的医疗保健消费、精神科诊断和药物治疗:嵌套在斯德哥尔摩大型 HIV 队列研究中的病例对照研究。

Health Care Consumption, Psychiatric Diagnoses, and Pharmacotherapy 1 and 2 Years Before and After Newly Diagnosed HIV: A Case-Control Study Nested in The Greater Stockholm HIV Cohort Study.

机构信息

From the Division for Family Medicine, Department of Neurobiology, Care Sciences and Society (Wändell, Ljunggren, Carlsson), Karolinska Institutet; Academic Primary Health Care Centre (Ljunggren, Carlsson); Skala Professionals AB (Jallow); and Centre for Psychiatry Research, Karolinska Institutet (Wahlström), Stockholm, Sweden.

出版信息

Psychosom Med. 2022 Oct 1;84(8):940-948. doi: 10.1097/PSY.0000000000001121. Epub 2022 Aug 20.

Abstract

OBJECTIVE

We compare individuals with newly diagnosed HIV with sex-, age-, and socioeconomic status-matched HIV-negative controls, with the aim of studying the frequency of health care visits, the types of clinics visited, registered diagnoses, and psychopharmacotherapy.

METHODS

The data were collected through the Stockholm Region administrative database (Stockholm Regional Health Care Data Warehouse) for men and women (people) living with newly diagnosed HIV (PLWH) in their medical records (930 men, 450 women) and controls. The odds ratios (ORs) with 99% confidence intervals (CIs) for psychiatric comorbidities and relevant pharmacotherapies were calculated during the 2011-2018 period.

RESULTS

Substance use disorder was higher in PLWH than in controls, before and after newly diagnosed HIV in men (OR = 1 year before 4.36 [99% CI = 2.00-9.5] and OR = 1 year after 5.16 [99% CI = 2.65-10.08]) and women (OR = 1 year before 6.05 [99% CI = 1.89-19.40] and OR = 1 year after 5.24 [99% CI = 1.69-16.32]). Health care contacts and psychiatric disorders were more common in cases than controls 1 and 2 years after diagnosis, particularly for depression in men 1 year after HIV (OR = 3.14, 99% CI = 2.11-4.67), which was not found in women (1 year OR = 0.94, 99% CI = 0.50-1.77).

CONCLUSIONS

Before newly diagnosed HIV, PLWH have the same level of psychiatric diagnoses as their controls, except for substance use disorder. Psychiatric problems are more common in PLWH than in their controls after newly diagnosed HIV.

摘要

目的

我们比较了新诊断为 HIV 的个体与性别、年龄和社会经济地位匹配的 HIV 阴性对照者,旨在研究就诊次数、就诊诊所类型、登记诊断和精神药理学治疗。

方法

数据是通过斯德哥尔摩地区行政数据库(斯德哥尔摩地区卫生保健数据仓库)收集的,包括新诊断为 HIV 的男性(930 人)和女性(450 人)患者及其对照者的病历。在 2011-2018 年期间,计算了精神共病和相关药物治疗的优势比(OR)及其 99%置信区间(CI)。

结果

与对照者相比,男性和女性新诊断 HIV 前(OR=1 年前 4.36[99%CI=2.00-9.5]和 OR=1 年后 5.16[99%CI=2.65-10.08])和新诊断 HIV 后(OR=1 年前 6.05[99%CI=1.89-19.40]和 OR=1 年后 5.24[99%CI=1.69-16.32])均存在更高的物质使用障碍。诊断后 1 年和 2 年,病例组的就诊次数和精神障碍更为常见,特别是男性新诊断 HIV 后 1 年的抑郁症(OR=3.14,99%CI=2.11-4.67),而女性则没有(1 年 OR=0.94,99%CI=0.50-1.77)。

结论

在新诊断为 HIV 之前,除了物质使用障碍,PLWH 与对照者的精神诊断水平相同。新诊断 HIV 后,PLWH 的精神问题比对照者更为常见。

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