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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of a study about psychiatric morbility in patients suffering from HIV infection treated in a psychiatric consulting department of a general hospital are presented. Out of one hundred of individuals studied, 93 showed a diagnosis in Axle I according to DSM-IIIR criteria for mental disorders classification. The diagnosis most frequently found was the one of disorders due to drugs dependence, in 41%; organic mental disorder in 29%; adaptation disorders in 15% and affective one in 5% of cases. In sixteen patients of the sample a follow-up was carried out finding ad evolution towards dementia. Diagnostic difficulties of this population and usefulness of carrying out a revision of diagnostic classifications usually employed are debated.
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PMID:[Neuropsychiatric aspects of HIV infection]. 185 24

Demographic and clinical data were recorded for 324 patients who visited an AIDS-related psychiatric outpatient clinic over a three-year period. Seventy-five percent of the patients had a diagnosis of AIDS, AIDS-related complex, or asymptomatic HIV seropositivity. Intravenous drug use and heterosexual relations were the most common HIV transmission risk factors. Seventy-three percent of the patients were black or Hispanic; 51 percent were female. In all stages of HIV infection, adjustment disorder was the most common diagnosis; one third to one half of the patients had substance abuse diagnoses. Only 5 percent were diagnosed with dementia, with the incidence highest (12 percent) in patients with AIDS. On the basis of their experience with the clinic, the authors discuss issues that have proved important in the treatment of patients with the triple diagnoses of medical illness, mental illness, and substance abuse.
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PMID:Characteristics of patients attending an HIV-related psychiatric clinic. 186 72

Ten years ago it might have been predicted that neurosyphilis would disappear, but this has not happened. It has altered in character so that almost all of the cases seen are meningovascular in type. Even with the acceleration of neurosyphilis that occurs with immunodeficiency it is unlikely that there will be a resurgence of tabes dorsalis, general paralysis of the insane (GPI) or gummatous involvement of the central nervous system. These entities are still reported as single cases in the literature and this is unlikely to change. Diagnostic vigilance is required in respect of meningovascular syphilis which presents in so many different guises, and it seems prudent to advocate that all patients admitted to hospital with a neurological or psychiatric disorder should have syphilis serology checked routinely, though it no longer seems necessary to perform the tests routinely on outpatients. Advances in serological testing have made the diagnosis of syphilis easier to establish, and further advances in the diagnosis of neurosyphilis are likely with the perfection of techniques to culture treponemes in the cerebrospinal fluid (CSF) or the detection of surface antigens in the CSF. Although syphilis remains a treatable disease the impact of AIDS has necessitated modifications to the treatment regime. It is now recommended that patients who are HIV-positive and who have early syphilis should be treated as for neurosyphilis, as the former regime for treating primary syphilis may not be adequate.
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PMID:Neurosyphilis yesterday and today. 158 38

The human immunodeficiency virus (HIV) epidemic has created a multidimensional crisis that is challenging the health care system. Individuals with or without risk behaviors have anxieties about acquired immunodeficiency syndrome (AIDS) and need support and counseling. Once symptoms of HIV infection develop, crisis intervention and support need to be integrated into ongoing medical care. A biopsychosocial approach enables persons with AIDS to develop strategies for coping, to improve adherence, and to prevent transmission and suicide. Persons with AIDS are confronted with severe illnesses, neuropsychiatric disorders, discrimination, and death. Each person deserves the best medical and psychologic care available and the services of other disciplines where indicated. Caregivers, anxious about contagion, are devastated by the complexity, severity, and multiplicity of the illnesses that comprise AIDS and the lack of adequate resources to combat the epidemic. AIDS is a paradigm of a medical illness that requires a biopsychosocial approach. Psychiatric sequelae complicate the HIV epidemic, affecting both the uninfected and infected. The psychiatric manifestations of the uninfected include anxiety, phobia, factitious disorder, delusions, and Munchausen's AIDS. Psychiatric disorders associated with HIV infection include organic mental disorders, substance abuse disorder, affective disorders, adjustment disorders, anxiety disorders, and personality disorders. The consultation-liaison (C-L) psychiatrist is in a unique position to clarify and treat the psychiatric complications and to provide leadership for multidisciplinary programs. The biopsychosocial approach enables persons with HIV infection, their loved ones, and caregivers to meet the challenges of the HIV epidemic with compassion, optimism, and dignity.
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PMID:Biopsychosocial approach to the human immunodeficiency virus epidemic. A clinician's primer. 240 16

The study describes the psychiatric disorders found in 100 HIV-positive patients, in different stages of the illness, at the psychiatric consultation service of a general hospital in Madrid. Eighty-five percent of the sample fell within the intravenous drug addicts risk group, which coincides with the epidemiological characteristics of Spain's HIV-positive population. The most frequently noted psychiatric diagnosis was substance dependence disorder (41%), followed by organic mental disorder (29%), adjustment disorder (15%), and affective disorder (5%). Fifteen percent of the subjects had depressive symptoms, and 11% expressed suicidal ideation. A follow-up conducted on part of the sample showed a development towards dementia, emphasizing diagnostic difficulties in the initial evaluation of these patients.
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PMID:Psychiatric aspects of patients with HIV infection in the general hospital. 248 87

Psychiatric disorders associated with human immunodeficiency virus (HIV) infection are increasingly prevalent. The psychologic, sociocultural, and medicolegal dimensions of HIV disease further fragment and complicate the care of these individuals. This article reviews the psychiatric aspects of HIV disease and suggests practical approaches to management and patient care.
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PMID:Psychiatric aspects of HIV disease. 266 57

HIV disease often leads to neuropsychiatric disturbance, either through direct infection of the brain by the virus or through CNS disease secondary to immunodeficiency. Neuropsychiatric complications of AIDS and AIDS-related disorders may present clinically as acute or chronic organic mental syndromes, or may mimic functional psychiatric illness, in particular depression, anxiety, or psychotic states. Two cases of hypomanic states in homosexual men suffering from AIDS are reported. Neither of the two men had a personal or family history of affective disorder. In one man, hypomanic symptoms were caused by early HIV encephalopathy; he rapidly developed typical HIV dementia with a marked downhill course. In the second case, a clear connection between the hypomanic symptoms and direct HIV brain involvement was not established.
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PMID:Two cases of hypomania in AIDS. 316 73

The background to HIV infection, its mode of transmission, and its neurological and psychiatric complications are described. The management of AIDS-related psychiatric disorder and problems encountered among staff involved in the management of patients suffering from AIDS are considered. There is a need for appropriate educational programmes. Although the incidence of AIDS in the UK has been appreciably lower than in many other countries, there are no grounds for complacency; psychiatric disorder associated with HIV infection will be encountered much more frequently in the future. Psychiatric staff are urged to inform and prepare themselves in anticipation of this development.
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PMID:AIDS-related psychiatric disorder. 332 37

We report on 79 patients of different stages of human immune deficiency virus (HIV) infection according to the Walter-Reed staging classification (WR). Comparing the HIV antibody content per weight IgG in serum and cerebrospinal fluid (CSF), 54 patients (68%) showed higher antibody activity in CSF than in serum, indicating intrathecal antibody production and thus a local challenge with the virus. The percentage of patients with these antibodies in CSF increased from stage WR 1 (33%) to WR 5 (90%). It decreased again in WR 6 (68%). Twenty-one patients with intrathecally produced antibodies but without evidence for opportunistic or preexistent neuropsychiatric diseases were further analyzed. Even in stages WR 1 and 2 these patients showed distinct clinical signs. These consisted mostly in apathic personality change (n = 13), peripheral neuropathy (n = 8) or mild hemisyndrome (n = 9). Progression to severe dementia solely caused by HIV encephalitis seems to be possible. More often acceleration of the mental disorder indicates a synergistic action of other pathogens. Our study gives further evidence for very frequent, early and clinically active involvement of the nervous system by the HIV infection.
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PMID:Early involvement of the nervous system by human immune deficiency virus (HIV). A study of 79 patients. 337 87

Four depressed and cognitively impaired patients with HIV-related disease had a marked therapeutic response to treatment with psychostimulants. Use of dextroamphetamine and methylphenidate brought a prompt remission of depressive and cognitive dysfunctions without adverse side effects. The results suggest the need for further evaluation of psychostimulants in the treatment of HIV patients whose depression proceeds from an affective disturbance (either primary or secondary) or from a specific organic mental disorder. The importance of neuropsychiatric assessment of depressed HIV patients is stressed, and diagnostic and treatment guidelines are given.
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PMID:Response of HIV-related depression to psychostimulants: case reports. 340 22


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