Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

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

Five cases of psychiatric illness, presenting as functional psychosis, occurring in male homosexuals with human immunodeficiency virus (HIV) infection are described and compared with similar cases in the literature. The association between psychosis and infection with HIV is discussed with particular emphasis on the significance of functional versus organic presentation.
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PMID:Psychosis associated with HIV infection. 307 97

A case-control study of heroin users in general practice showed a prevalence of roughly two per 1000 of the urban population or four per "average" general practice list of patients. A method of studying heroin users who attend general practice was used that has advantages over existing techniques. Thirty six heroin users had a statistically significantly higher yearly doctor-patient consultation rate than a group of matched controls. More heroin users also failed to attend appointments than controls. When consultations directly related to heroin and its effects were excluded, however, the consultation rates in the two groups were similar. The heroin users did not have an excess of psychiatric disorder or disturbed family background compared with controls but had a noticeable history of dishonest and violent behaviour towards medical staff. A high proportion of heroin users in the study were antibody positive for the human immunodeficiency virus. General practitioners should take advantage of their frequent contacts with heroin users and their families to give them support and counselling about the acquired immune deficiency syndrome.
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PMID:Heroin users in general practice: ascertainment and features. 312 63

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

Alterations of sleep structure have been reported in asymptomatic human immunodeficiency virus (HIV)-infected subjects. In these patients some authors have found an increased percentage of slow wave sleep (SWS) and a SWS preponderance in the second half of the night, as well as subjective sleep complaints. Other authors have found an increased stage 1 non-rapid eye movement (NREM) and reduced stage 2 NREM percentages in asymptomatic subjects. We evaluated the macrostructure and the microstructure (cyclic alternating pattern, CAP) of sleep in nine HIV-infected asymptomatic men without sleep complaints or psychiatric illness, in comparison with nine age-matched controls. Our study showed a decreased amount of SWS and a significantly higher CAP rate in HIV-subjects, suggesting an altered organization of the sleep process in these patients.
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PMID:Slow wave sleep and cyclic alternating pattern (CAP) in HIV-infected asymptomatic men. 748 16

The prevalence of tuberculosis in the homeless is on the rise. The presence of human immunodeficiency virus and multidrug-resistant tuberculosis in the homeless has contributed to this high prevalence. Several factors, including alcoholism, substance abuse, and psychiatric illness, combine to make it difficult to diagnose and treat tuberculosis in the homeless. Medical providers are likely to encounter homeless individuals in a number of settings, including emergency departments, community and free clinics, public hospitals, and health maintenance organizations. Appropriate screening, prevention, and treatment should be undertaken in collaboration with local health departments. The use of directly observed therapy and of the treatment regimens published by the Centers for Disease Control and Prevention improves treatment outcomes among the homeless.
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PMID:Tuberculosis in the homeless. 777 31

This article describes a study undertaken to determine the prevalence of human immunodeficiency virus (HIV) infection and risk factors associated with HIV infection in a chronically mentally ill population. Patients were eligible for inclusion in the survey at their first outpatient or inpatient admission to a Maryland state psychiatric hospital between August 1990 and July 1991. Demographic and risk behavior information was collected, and unlinked HIV antibody testing was performed on blood specimens drawn for routine clinical purposes. Of 533 patients surveyed, 31 patients (5.8%) were infected with HIV. The prevalence of HIV infection was 36.4% among female patients reporting intravenous drug use and 14.5% among their male counterparts. The prevalence of HIV infection among homeless patients was 10.1%; 88.9% of those HIV infected also reported intravenous drug use. On admission, 90% of patients reported no knowledge of their HIV antibody status; 4.1% of these patients were HIV infected. The data confirmed the risk of HIV infection in this population of chronically mentally ill individuals. Risk reduction programs designed specifically for individuals with chronic mental illness need to be developed.
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PMID:HIV seroprevalence in a chronically mentally ill population. 806 2

The present study determined lifetime and current psychiatric functioning in a sample of homosexual or bisexual men at various stages of human immunodeficiency virus (HIV) infection in order to address several questions regarding the relationship between psychopathology and HIV infection. HIV+ asymptomatic or symptomatic and HIV- homosexual or bisexual men completed self-report measures of psychological and health functioning and participated in structured diagnostic interviews. Additional information regarding HIV-related life events and their potential relationship to onset of disorder and family history of psychiatric disorder were obtained. A high lifetime prevalence of affective and substance use disorder was found, with almost one half of the sample meeting criteria for both disorders. Lifetime affective disorder diagnosis was associated with a positive family history of affective disorder. HIV-related events were most closely associated with onset or recurrence of affective disorder compared with other disorders. Low current rates of psychiatric disorder and levels of emotional distress were found, with no differences in degree of psychiatric adjustment across stage of infection. We conclude that the lifetime prevalence of certain categories of psychiatric disorder is high in both HIV+ and HIV- homosexual samples. Increased rates of psychiatric disorders do not appear to be a consequence of HIV infection. However, episodes of illness, particularly affective disorder, may develop following an HIV-related event such as confirmation of infection. Although symptomatic subjects have more somatic difficulties, there appears to be no relationship between stage of illness and level of emotional distress.
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PMID:Psychopathology in human immunodeficiency virus infection: lifetime and current assessment. 833 32

The feasibility of on-site primary care services and their use by human immunodeficiency virus HIV-seropositive and seronegative injecting drug users within an outpatient methadone maintenance program are examined. A 16-month prospective study was conducted within an ongoing cohort study of HIV infection at a New York City methadone program with on-site primary care services. The study group consisted of 212 seropositive and 264 seronegative drug injectors. A computerized medical encounter data base, with frequencies of primary care visits and with diagnoses for each visit, was linked to the cohort study data base that contained information on patients' demographic characteristics, serologic status, and CD4+ T-lymphocyte counts. Eighty-one percent of the drug injectors in the study voluntarily used on-site primary care services in the methadone program. Those who were HIV-seropositive made more frequent visits than those who were seronegative (mean annual visits 8.6 versus 4.1, P < .001), which increased with declining CD4+ T-lymphocyte counts; 79 percent of those who were seropositive with CD4 counts of less than 200 cells per cubic millimeter received on-site zidovudine therapy or prophylaxis against Pneumocystis carinii pneumonia, or both. Common primary care diagnoses for patients seropositive for HIV included not only conditions specific to the human immunodeficiency virus but also bacterial pneumonia, tuberculosis, genitourinary infections, asthma, dermatologic disease, psychiatric illness, and complications of substance abuse; those who were seronegative were most frequently seen for upper respiratory infection, psychiatric illness, complications of substance abuse, musculoskeletal disease, hypertension, asthma, and diabetes mellitus. Vaginitis and cervicitis,other gynecologic diseases, and pregnancy were frequent primary care diagnoses among both seropositive and seronegative women.
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PMID:Utilization of on-site primary care services by HIV-seropositive and seronegative drug users in a methadone maintenance program. 839 79


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