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Mental health disorders and sexually transmitted diseases
in a privately insured population.
American Journal of Managed Care 2004;10(12):917-924.
Rein DB, Anderson LA, Irwin KL.
Abstract
OBJECTIVES: To consider whether patients who use mental health services in
privately insured settings are also more likely to have received sexually
transmitted disease (STD) or human immunodeficiency virus (HIV) diagnoses
and whether this relationship extends to patients with milder mental health
disorders. METHODS: Using frequency tables stratified by age and sex, a logistic
regression model, and difference of means tests, we examined the relationship
between mental health claims and STDs in a sample of 289 604 privately insured
people across the United States. RESULTS: Patients with mental health claims
were more than twice as likely as other patients to have an STD claim in
the same year after controlling for confounding factors (odds ratio, 2.33;
95% confidence interval, 2.11-2.58). This relationship held for severe and
milder mental health diagnoses, for male and female patients, and in each
age category from 15 to 44 years. Among women, patients aged 20 to 24 years
with a mental health claim had the highest predicted probability of STD diagnoses
(3.0%); among men, patients aged 25 to 29 years with a mental health claim
had the highest predicted probability of STD diagnoses (1.2%). CONCLUSIONS:
In this population, patients with mental health claims were more likely to
also have claims with diagnoses for STDs than patients without mental health
claims, and this relationship applied to severe and milder mental health
disorders. This suggests that people with mental health disorders in privately
insured populations may benefit from routine STD risk assessments to identify
high-risk patients for referral to cost-effective preventive services.