This week, we highlight some unsettling research into bipolar disorder and PrEP access, help for perinatal depression, and a TD case study.
Yet PrEP Access Remains Alarmingly Low
A new national study in The Journal of Clinical Psychiatry shows that commercially insured people with bipolar disorder are being diagnosed with HIV at alarmingly high rates. And yet, they have a hard time getting access to one of the most effective prevention tools: preexposure prophylaxis (PrEP).
The study’s authors examined insurance claims for 333,867 patients between 2010 and 2022. They uncovered 435 new HIV cases. That’s more than 10 times the national average.
Despite that elevated risk, fewer than 0.5% of individuals with bipolar disorder received PrEP at any time. And even among those with repeated sexually transmitted infection (STI) encounters, fewer than 4% received a prescription.
The likelihood of receiving PrEP also varied dramatically based on clinical and demographic factors. Men were more than 10 times more likely than women to receive a prescription. And patients with documented high-risk sexual behavior – or stimulant use disorder – boasted greater odds of PrEP use.
On other hand, those with opioid or cannabis use disorders appeared to be less likely to receive a prescription.
The study also exposed a yawning gap tied to where patients receive care. Individuals who saw only psychiatrists for outpatient care were more likely to be diagnosed with HIV. They were also less likely to receive PrEP than those who saw primary care clinicians.
The researchers suggest that integrating PrEP evaluation (and prescribing) into psychiatric care could help expand prevention access.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- The Primary Care Companion for CNS Disorders has shared a case study that shows that a low-dose tetrabenazine prescription triggered rapid, severe suicidality in a 19-year-old with schizophrenia and OCD.
- Additional JCP research reveals that peer-administered interventions are effective at improving perinatal depression, while peer-delivered psychotherapies are the most effective.
- Another PCC report explores the case of a woman misdiagnosed with tardive dyskinesia who was ultimately found to have Huntington disease.
- A new drug trial offers some hope for patients living with narcolepsy.
- And don’t forget to check out the latest episode of “The JCP Podcast,” where Dr. Stephen Brannan chats with our very own Dr. Ben Everett.
