To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - APA MEETING: HIV Infection Associated With Psychiatric Symptoms URL: http://www.pslgroup.com/dg/100D2E.htm Doctor's Guide May 27, 1999
By John L. Moore Special to DG News WASHINGTON, DC -- May 27, 1999 -- HIV infected patients require psychiatric care in order to treat the associated symptoms of depression and dementia, said Dr. Constantine Lyketsos, M.D., of Johns Hopkins University. Dr. Lyketsos presented his review of the psychiatric effects of HIV infection last week at the American Psychiatric Association meeting in Washington, DC. Early during the infection, patients demonstrate cognitive symptomatology, whereas dementia occurs later in the course of the disease, he explained. Neurological manifestations of HIV infection progress through the stages of initial neuropsychiatric impairment followed by minor motor disorders and, in four to seven percent of the patients, dementia. These neuropsychiatric changes are associated with increased viral load in the cerebrospinal fluid and are paralleled by progression from CDC stage A to CDC stage C. Dr. Lyketsos said the most important long-term objective that should be set for these patients is compliance with antiretroviral therapy of at least 90 percent. The elevated rate of depression in early HIV infection is a reflection of the accumulation of social stressors in the population at risk as well as the biological effects of HIV on the brain, he added. The increase in both moderate and severe depression coincides with the conversion from HIV seropositivity to AIDS. Mania is diagnosed in approximately four to eight percent of patients with HIV, which is directly associated with the effects of HIV on the brain, Dr. Lyketsos said. Standard treatment of mania in the HIV infected population is recommended in the early stages of the infection, he explained. Neuroleptics are preferred during the later stages because of potential toxic effects and drug interactions associated with carbamazepine and divalproex. Lithium carbonate therapy is contraindicated. Dr. Glenn Treisman, of Johns Hopkins University said that those contracting HIV in recent years generally have numerous psychiatric comorbidities and require psychiatric attention at the primary care level. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.