Analyses of Nursing Home Residents With HIV and Depression Using the Minimum Data Set

Depressive disorders are common among people with HIV disease, with observed lifetime rates as high as 40-48 percent. People with HIV are approximately twice as likely to have had a recent episode of a major depressive disorder than people without HIV. The rate of major depressive disorders in people with HIV disease is similar to rates reported for people with other chronic conditions such as cancer or heart disease. A study of people with HIV in nursing homes shows that more than 20 percent of these patients also had a diagnosis of depression at admission.

The current study used analyses of the Minimum Data Set (MDS) for Nursing Home Resident Assessment and Care Screening to develop and analyze comprehensive profiles of nursing home residents with HIV who also had a diagnosis of depression and compare them to profiles of residents with HIV without a diagnosis of depression. The researchers analyzed 5,114 MDS admission assessments from June 23, 1998 through Jan. 17, 2000 for residents with HIV.

Residents with HIV and depression were significantly more likely to be older, female and white than other residents with HIV. Residents with HIV and depression were twice as likely as other residents with HIV to have a history of mental health conditions, and they were significantly more likely to have unsettled relationships. However, there were no significant differences between these two groups of residents with HIV in levels of physical disability or in cognitive ability.

Residents with HIV and depression were significantly more likely to have unstable health conditions, to be at the end stage of the disease, and to have other diseases and infections than other residents with HIV. One-third of residents with HIV and depression did not receive antidepressants, and most had not been evaluated by a mental health specialist in the last 90 days or received psychological therapy in the previous seven days.

"These analyses of the MDS indicated that many residents with HIV and depression are not receiving antidepressant medications or mental health services in nursing homes," the authors concluded. "Additional research is needed to determine how the mental health needs of residents with HIV change as their length of stay in the nursing home increases. Also, future research should analyze the care that people with HIV receive in nursing homes to determine how various mental health, physical, and cognitive therapies affect the health status of people with HIV over time."

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