Under-documentation of psychiatric diagnoses among persons living with HIV in electronic medical records

ABSTRACT

Persons living with HIV (PLWH) are significantly more likely to meet criteria for a psychiatric disorder compared to the general population. To our knowledge there are no prior studies that report rates of psychiatric diagnosis documentation in electronic medical records (EMRs) of PLWH. The goal for this study was to report the rates of a variety of psychiatric diagnoses among PLWH in electronic medical records. Participants (n = 2,336) were enrolled in the Center for AIDS Research (CFAR) Longitudinal Database study at the University of Pennsylvania, Philadelphia, PA. Diagnostic codes were extracted from the EMR for depressive disorders, alcohol and substance use disorders, PTSD, sleep disorders, and adjustment disorders and were compared to rates from national epidemiological studies. Rates of Major Depressive Disorder in the EMR were comparable to prior reports on HIV-infected samples. In contrast, rates of PTSD, substance use disorders, alcohol use disorders, adjustment disorders and insomnia from the EMR were all markedly lower compared to national estimates for HIV-infected samples. While clinicians appropriately documented evidence of Major Depressive Disorder, other psychiatric comorbidities were largely overlooked. These findings suggest a potential bias in how clinicians either detect or document psychiatric disorders in PLWH.

KEYWORDS:

• HIV
• mental illness
• electronic medical records
• major depression
• PTSD

Acknowledgements

The authors would like to thank participants in the Center for AIDS Research (CFAR) in Philadelphia, PA for providing their valuable health information.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This publication resulted (in part) from research supported by the Mid-Atlantic CFAR Consortium (MACC) Scholars Program, an inter-CFAR collaboration between the District of Columbia Center for AIDS Research (P30 AI117970), the University of Pennsylvania CFAR (P30 A1 045008), and the Johns Hopkins University CFAR (P30 A1 094189). This collaboration is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH … /../../TandF/CAIC/CAIC1713974/10.13039/100006492