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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. Nurses who care for AIDS patients are challenged to effectively manage two common problems: AIDS dementia complex (ADC) and depression. 2. Nurses can briefly assess certain neuropsychological functions related to ADC and differentiate dementia from depression. 3. Nursing interventions to manage the behaviors associated with ADC and depression can ensure patients' safety and promote the quality of their lives.
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PMID:Dementia & depression in persons with AIDS: causes and care. 228 38

The use of neuroleptic medication as antiemetics, or in the treatment of neuropsychiatric disorders in patients with AIDS, may be associated with extrapyramidal side effects and lead to difficulty with diagnosis and management. Two cases are presented that describe severe extrapyramidal syndromes occurring in two patients with AIDS, one treated with prochlorperazine and the other with prochlorperazine and metoclopropramide. It is possible that the neuropathologic lesions found in patients with the AIDS dementia complex may pre-dispose to extrapyramidal side effects of neuroleptic medication. The differential diagnosis and treatment of delirium, dementia, depression, and extrapyramidal reactions in patients with AIDS is discussed.
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PMID:Extrapyramidal reactions. Neuropsychiatric mimics in patients with AIDS. 256 9

Although the medical and psychosocial problems posed by acquired immune deficiency syndrome (AIDS) are unique, interventions to treat AIDS-related psychiatric disorders are currently available. The depression, delirium, and denial that occur in medically hospitalized patients with AIDS respond to standard psychotherapeutic and psychopharmacological approaches. Outpatients with AIDS or AIDS-related complex benefit from clarification, abreaction, and support if the therapist accepts the regression associated with the sick role, focuses initially on somatic rather than on psychological concerns, and overcomes unwarranted fears of contagion. Patients with AIDS-related dementia are helped considerably by early diagnosis and planning, and patients with antibodies to the AIDS virus require a psycho-educational approach that includes stress inoculation and problem-solving techniques. The authors describe the above interventions as well as common countertransference responses that impede their implementation.
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PMID:Psychiatric interventions for AIDS-spectrum disorders. 353 Sep 57

Studies have shown an increased vulnerability to psychological distress and a significant prevalence of psychiatric disorders associated with HIV-1 infection, in the range of 30-63%. Infection with HIV-1 may also lead to a number of neurological complications, including AIDS dementia complex. The incidence of HIV-1 dementia is approximately 7 per 100 patients per year following the development of AIDS, with up to 20% of HIV-1-infected individuals receiving a diagnosis of HIV-1 dementia before death. A recent study, however, found no significant decline in cognitive functions before AIDS, unless overt dementia is present. To learn more about the prevalence and natural history of psychiatric, neuropsychological, and neurological complications of HIV-1 infection, the World Health Organization (WHO) conducted the WHO Neuropsychiatric AIDS Study. Findings are based upon the cross-sectional study and longitudinal follow-up of 203 subjects recruited in Nairobi, Kenya, and 205 in Kinshasa, Zaire. The author reports finding a significantly higher mean global score on the Montgomery-Asberg Depression Rating Scale in symptomatic HIV-seropositive individuals compared to in matched seronegative controls. Overall, the study data suggest that the risk of subtle cognitive deficits may be increased during the asymptomatic stages of HIV-1 infection.
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PMID:Neuropsychiatric HIV-1 infection study: in Kenya and Zaire cross-sectional phase I and II. 855 77

Increasing evidence suggests that the detrimental effects of glucocorticoid (GC) hypersecretion occur by activation of the hypothalamic-pituitary-adrenal (HPA) axis in several human pathologies, including obesity, Alzheimer's disease, AIDS dementia, and depression. The different patterns of response by the HPA axis during chronic activation are an important consideration in selecting an animal model to assess HPA axis function in a particular disorder. This article will discuss how chronic HPA axis activation and GC hypersecretion affect hippocampal function and contribute to the development of obesity. In the brain, the hippocampus has the highest concentration of GC receptors. Chronic stress or corticosterone treatment induces neuropathological alterations, such as dendritic atrophy in hippocampal neurons, which are paralleled by cognitive deficits. Excitatory amino acid (EAA) neurotransmission has been implicated in chronic HPA axis activation. EAAs play a major role in neuroendocrine regulation. Hippocampal dendritic atrophy may involve alterations in EAA transporter function, and decreased EAA transporter function may also contribute to chronic HPA axis activation. Understanding the molecular mechanisms of HPA axis activation will likely advance the development of therapeutic interventions for conditions in which GC levels are chronically elevated.
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PMID:Detrimental effects of chronic hypothalamic-pituitary-adrenal axis activation. From obesity to memory deficits. 982 46

Presentations from the Seventh Neuroscience of HIV Infection assembly are highlighted. AIDS dementia was first identified 10 years ago, but there have been few advances in its treatment. AIDS research has been devoted to the immune system disorder, and neurologic problems are less straightforward to address. AIDS dementia is a widely feared disorder; it strips patients of their dignity and complicates their care. Tests used to determine early symptoms of psychomotor dysfunction are discussed. Novel treatments used to treat dementia, myopathy, depression, and pain are examined.
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PMID:HIV and the mind. 1136 93

This short review address the concept of cytokine and cytokine families, their relationship with CNS, cytokine effects on nervous system (namely, sickness behavior) and the cellular source of brain cytokines. In addition, it provides selected data on the role of cytokines in mental disorders such as depression, schizophrenia, Alzheimer's disease and AIDS-related dementia.
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PMID:[Cytokines and psychiatry]. 1219 20

Dementia affects about 5% of the elderly population over age 65 years and has an unexplained predominance in women and a low rate in some cultures. Different forms of dementia are now distinguished-Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementia, and dementia secondary to disease, such as AIDS dementia. However, such nosological boundaries are being re-evaluated because different dementias are believed to have common underlying neuropathology. Neurochemical and neurobiological research has led to advances in understanding causes of dementia, and functional imaging has allowed identification of possible biomarkers; from these, a range of potential treatment approaches have arisen that focus on enhancement of neurotransmitter function, intervention at the level of amyloid production and deposition, and reduction of secondary risk factors such as hypertension, depression, and hypolipidaemia. Molecular diagnostic testing and genetic counselling for families with autosomal dominant early-onset dementia are new developments; however, this approach is not useful for late-onset dementia, in which the identified candidate susceptibility genes have a relatively small effect on risk. While fundamental research works towards new biological treatment strategies, much remains to be done in the area of disease management and the development of appropriate models of long-term care.
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PMID:The dementias. 1268 69

To examine the relationship between cognitive impairment and desire for death in patients with advanced AIDS we evaluated 128 patients with advanced AIDS consecutively admitted to three long-term care facilities. Participants completed a clinical assessment that included a self-report measure of desire for hastened death in the medically ill (Schedule of Attitudes toward Hastened Death), three measures of cognitive functioning designed to screen for cognitive impairment (Dementia Rating Scale, Mini-Mental State Exam, HIV Dementia Scale), and other measures of physical and psychological functioning. Participants who were classified as cognitively impaired obtained significantly higher scores on the measure of desire for death than did patients without cognitive impairment. This modest association between cognitive impairment and desire for death remained significant even after controlling for the impact of depression on desire for death. Specific aspect of cognitive functioning such as memory and psychomotor coordination appeared to be more salient than executive functioning or abstract reasoning. Cognitive impairment appears to have a modest, but significant impact on patients' desire for hastened death. Aggressive treatment of cognitive symptoms in the terminally ill is necessary in order to disentangle the various factors that may drive end-of-life treatment decisions.
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PMID:The role of cognitive impairment in desire for hastened death: a study of patients with advanced AIDS. 1274 32

Neuropsychiatric complications of human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS) may present clinically as acute or chronic organic brain syndrome, or mimic functional psychiatric diseases. Among such psychiatric diseases, mania tends to occur with increased frequency after the onset of AIDS. We report a case in which manic manifestations were noted before the diagnosis of AIDS. The patient had no past or family history of mood disorders, but had risk factors for HIV infection. He had a rapid downhill course from initial manic symptoms to depression, dementia and then death within 10 months. Such rapid cognitive deterioration into AIDS dementia after mania is consistent with previous reports. Cases like this will become more common with spread of the AIDS pandemic in Asian regions, including Taiwan. Clinicians should be mindful of HIV infection/AIDS as a differential diagnosis in patients with manic episodes and risk factors for HIV infection.
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PMID:Association of AIDS and bipolar mania with rapid progression to dementia and death. 1575 22


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