European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S657
EV963
Depression among HIV-infected
patients–a reality that must not be
forgotten
M. Marinho ∗, M. Mota-Oliveira , M.J. Peixoto , J. Marques ,
M. Braganc¸ a
1 São João hospital centre, clinic of psychiatry and mental health,
Porto, Portugal
2 Local healthcare unit of Matosinhos, clinic of psychiatry,
Matosinhos, Portugal
3 Faculty of medicine of Porto university, department of clinical
neurosciences and mental health, Porto, Portugal
∗ Corresponding author.
Introduction HIV-infection is a very stigmatized, chronic disease
with increased rates of psychiatric disorders, being major depres-
sion the most common.
Objective To review the recent research related to depression in
HIV-infected patients.
Methods Literature review based on PubMed/Medline, using the
keywords “HIV” and “depression”.
Results HIV-infected patients have a chance 2-7 times higher
of developing major depression, around the time of diagnosis or
during the course of their illness. However, only fewer than 50%
of the cases are recognized clinically. Several factors contribute
to its under-recognition and under-treatment, such as the over-
lap between the neurovegetative symptoms of depression, the
somatic symptoms of HIV disease, and the effects of comorbid dis-
eases; the mistaken belief that depressive symptoms are expected
in this group; the neuropsychiatric side effects associated with
some antiretrovirals. Besides, major depression presents important
diagnostic challenges due to biological, psychological, and social
components associatedwith the infection. The authors will analyze
the clinical presentation.
Depression has been associated with a negative impact on qual-
ity of life, poorer HAART adherence, faster HIV disease progression
and increased mortality risk. Importantly, however, appropriate
psychiatric intervention can do it over. In fact, studies suggest
that patients receiving SSRI treatments for depression have rates
of adherence and CD4+ T-cell counts similar to non-depressed
patients receiving HAART.
Conclusions The high prevalence of major depression in HIV-
positive individuals and its serious consequences if untreated,
increase even further the importance of its effective identification
and subsequent treatment in this group of patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV964
Anxiety among HIV-infected patients
– when anxiety is a disorder and not
simply a natural reaction to a
life-threatening illness
M. Marinho ∗, A. Amaral , E. Pereira , J. Marques ,
M. Braganc¸ a
1 São João hospital centre, clinic of psychiatry and mental health,
Porto, Portugal
2 Local healthcare unit of Matosinhos, clinic of psychiatry,
Matosinhos, Portugal
3 Faculty of medicine of Porto university, department of clinical
neurosciences and mental health, Porto, Portugal
∗ Corresponding author.
Introduction HIV infection is a chronic disease characterized by
a great deal of uncertainty and unpredictability, being anxiety dis-
orders a frequent psychiatric problem.
Objective To provide an overview of anxiety in HIV-infected
patients.
Methods Literature review based on PubMed/Medline, using the
keywords “HIV” and “anxiety disorders”.
Results HIV-infected individuals can experience symptoms of
anxiety across the spectrum of anxiety disorders. Adjustment dis-
order with anxious mood is the most common diagnosis, followed
by generalized anxiety disorder and panic disorder. Some patients
present with these disorders prior to notification, others develop
them during the course of their illness, mainly at key moments. In
HIV-infected patients, anxiety can be a manifestation of side effects
of medication; a symptomof an illness associatedwith HIV disease;
or, most commonly, the psychological response to the stressors of
the illness. In fact, many issues are responsible for the anxiety expe-
rienced by people living with HIV. The authors will analyze them.
Besides the distress of anxiety disorders, these lead to a decrease
in adherence to antiretroviral treatments, resulting in adverse pro-
gression of HIV disease and increased risk of mortality. Importantly,
however, appropriate psychiatric intervention can do it over.
Conclusions Careful diagnosis and treatment of anxiety disorders
in the context of HIV disease is even important, given the serious
effects if untreated. Thus, anxiety should never be seen simply as a
natural reaction to a life-threatening illness.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV965
AIDS mania – is it a potential indicator
to initiate HAART?
M. Marinho ∗, J. Marques , M. Braganc¸ a
1 São João hospital centre, clinic of psychiatry and mental health,
Porto, Portugal
2 Local healthcare unit of Matosinhos, clinic of psychiatry,
Matosinhos, Portugal
3 Faculty of medicine of Porto university, department of clinical
neurosciences and mental health, Porto, Portugal
∗ Corresponding author.
Introduction Mania occurs in higher rates among individuals
withHIV/AIDS, especiallywith the progression of HIV infection, and
constitutes an additional risk factor for facilitate the HIV spread.
Objective To provide an overview of secondary mania in HIV-
infected patients.
Methods Literature review based on PubMed/Medline, using the
keywords “HIV”, “AIDS” and “mania”.
Results Secondary mania or AIDS mania may be due to illicit or
prescribed drugs, CNS infection with HIV, medical illness, including
opportunistic infections. Of these, HIV neurotoxicity has been pro-
posed to be the most important factor in its pathogenesis. Mania
AIDS differs from primary mania with regard to clinical presenta-
tion, course, management and prognosis. The authors will analyze
them. Besides decrease to treatment adherence, maniac symptoms
also predispose to HIV risk behaviors, which may lead to further
HIV transmission. Importantly, the occurrence of HIV mania may
announce the transition from HIV infection to AIDS perhaps before
other clinical signs are evident. Early recognition and treatment of
manic symptoms with mood stabilisers, antipsychotics and HAART
improve quality of life, protect from further cognitive deterioration
and decrease mortality. In these patients, medication side-effects
toxicity, drug interactions, and adherence require special attention.
Conclusions Mania has been associated with HIV/AIDS and in
many instances acts as a barrier to achieving best treatment out-
comes. Thus, psychiatrists need to be aware of the complexities
involved in the emergence of manic episodes in HIV-infected
patients in order to deal with them in the most appropriate and
effective manner.