Table of Contents Table of Contents
Previous Page  661 / 812 Next Page
Information
Show Menu
Previous Page 661 / 812 Next Page
Page Background

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

1 ,

, M. Mota-Oliveira

1

, M.J. Peixoto

1

, J. Marques

2 , 3

,

M. Braganc¸ a

1 , 3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1948

EV964

Anxiety among HIV-infected patients

– when anxiety is a disorder and not

simply a natural reaction to a

life-threatening illness

M. Marinho

1 ,

, A. Amaral

1

, E. Pereira

1

, J. Marques

2 , 3

,

M. Braganc¸ a

1 , 3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1949

EV965

AIDS mania – is it a potential indicator

to initiate HAART?

M. Marinho

1 ,

, J. Marques

2 , 3

, M. Braganc¸ a

1 , 3

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.