HIV and Depression: Examining Medical Students Clinical Skills.

Eliut Rivera-Segarra,Paola Carminelli-Corretjer,Torsten B Neilands,Lawrence H Yang,Guillermo Bernal,Nelson Varas-Díaz

doi:10.3389/fpsyt.2020.00240

Abstract

Major depression is a prevalent psychiatric disorder among people living with HIV (PWH). Major depression symptoms, including suicidal ideation, can hinder clinical care engagement and anti-retroviral treatment adherence. Research suggests that inquiry about major depression symptomatology and suicidal ideation should be standard practice when offering primary care services to PWH. However, studies examining depression and suicidal ideation inquiry are scarce. This study’s aim was to describe medical students’ clinical skills for dealing with major depression symptomatology and suicidal ideation among PWH in Puerto Rico. A total of 100 4th year medical students participated in a Standardized Patient simulation with a trained actor posing as a PWH and with a previous major depression diagnosis. One-way frequency tables were used to characterize the sample and the percentage of each observed clinical skill. Two key findings stem from these results only 10% of the participants referred the patient to psychological/psychiatric treatment, and only 32% inquired about suicidal ideation. Our findings highlight the need for enhancing medical students’ competencies regarding mental health issues, particularly when providing services to at risk populations such as PWH within primary care settings.

Highlights

As of 2018, more than 49,000 cumulative cases of HIV/AIDS have been recorded in Puerto Rico since the 1980’s (HIV/AIDS Surveillance Program, Puerto Rico Health Department, 2018)
The documented clinical skills exhibited by participants during Standardized Patient (SP) interactions evidence a concerning scenario for potential clients
Screening for Major depressive disorder (MDD)—Our results evidence that 56% did not ask the patient if they had been previously diagnosed with MDD, nor inquired about MDD symptomatology, even though the patient mentioned feeling depressed

Summary

Introduction

As of 2018, more than 49,000 cumulative cases of HIV/AIDS have been recorded in Puerto Rico since the 1980’s (HIV/AIDS Surveillance Program, Puerto Rico Health Department, 2018). MDD is generally characterized by decreased interest and pleasure in daily activities, changes in sleep patterns and appetite, feelings of guilt or worthlessness, inability to Medical Students Clinical Skills concentrate, and impaired social functioning present during at least 2 weeks [4]. It can have negative implications for individuals already dealing with a challenging chronic disease. In Puerto Rico, an estimated prevalence of 22% of suicide behaviors has been documented among PWH, almost four times higher than the general population [6]

Methods

Results

Conclusion