Journal Article

Major Depression Disorder Increases 30-Day Hospital Readmissions

BOTTOM LINE

Major depression disorder (MDD) is a common psychiatric comorbidity in persons living with HIV (PLWHIV).  MDD is more common in PLWHIV than in the general population. An existing health care data base was used to investigate factors involved with 30-day hospital readmission frequency. The 30-day readmission rate was higher in the older age group, white persons, non-adherence with antiretroviral therapy and those from rural areas.  However, of major importance was that MDD was found to be very common in those readmitted to the hospital.  During hospitalization of PLWHIV it is very important to address MDD issues in order to reduce readmission of PLWHIV.

ABSTRACT

Background Major depression disorder (MDD) is the most common psychiatric comorbidity in patients living with HIV (PLWHIV). The prevalence rate of MDD is higher in PLWHIV in comparison to the general population. In our study, we focus specifically on the 30-day readmission rate of PLWHIV and severe major depression. Methods The Health Care Agency (HCA) databank was used to conduct a retrospective study on PLWHIV and severe MDD. Keywords such as HIV, severe MDD, CD4, viral load were used to identify the data. 30-day readmission rate is studied in PLWHIV and severe MDD (N=143). Variables such as age, sex, gender, adherence to antiretroviral medications, cluster of differentiation 4 (CD4), and viral load were studied in this population. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria were used to diagnose severe MDD in PLWHIV. An antiretroviral therapy (ART) medication list was used to analyze adherence in this population group. Geographical locations were identified using urbanization codes. Results Logistic regression analysis for the 30-day readmission rate in PLWHIV was found to be higher in the older age group (p<0.01). Caucasian population (p<0.01) and rural areas (p<0.01), ART non-adherence (p<0.05), and severe major depression were also found to be significant in this population (p<0.01). Conclusion As more patients live longer with HIV/AIDS, it gives rise to illnesses such as anxiety, depression, and cognitive impairment. Thus, it is important to identify severe depression in PLWHIV since it can have an impact on rates of hospitalization, morbidity/mortality, and the financial burden, specifically within 30-days of discharge.

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