A Biopsychosocial Approach to Psychiatric Consultation in Persons with HIV and AIDS

2010 ◽  
Author(s):  
Sharon M. Batista ◽  
Joseph Z. Lux
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Hiv Infection ◽  
Medical Care ◽  
Psychiatric Disorders ◽  
Posttraumatic Stress ◽  
Risk Reduction ◽  
Stress Disorder ◽  
Hiv And Aids ◽  
Psychiatric Consultation ◽  
End Stage

For persons with HIV and AIDS, a thorough and comprehensive assessment has far-reaching implications not only for compassionate, competent, and coordinated care but also for adherence to medical treatment and risk reduction, as well as public health. Primary physicians, HIV specialists, as well as psychiatrists and other mental health professionals can play an important role in preventing the spread of HIV infection. Psychiatric disorders are associated with inadequate adherence to risk reduction, medical care, and antiretroviral therapy. While adherence to medical care for most medical illnesses has major meaning to patients, loved ones, and families, adherence to medical care for HIV and AIDS has major implications for reduction of HIV transmission and prevention of emergence of drug-resistant HIV viral strains (Cohen and Chao, 2008). Many persons with HIV and AIDS have psychiatric disorders (Stoff et al., 2004) and can benefit from psychiatric consultation and care. The rates of HIV infection are also higher among persons with serious mental illness (Blank et al., 2002), indicating a bidirectional relationship. Some persons with HIV and AIDS have no psychiatric disorder, while others have a multiplicity of complex psychiatric disorders that are responses to illness or treatments or are associated with HIV/AIDS (such as HIV-associated dementia) or multimorbid medical illnesses and treatments (such as hepatitis C, cirrhosis, end-stage liver disease, HIV nephropathy, end-stage renal disease, anemia, coronary artery disease, and cancer). Persons with HIV and AIDS may also have multimorbid psychiatric disorders that are co-occurring and may be unrelated to HIV (such as posttraumatic stress disorder, or PTSD, schizophrenia, and bipolar disorder). The complexity of AIDS psychiatric consultation is illustrated in an article (Freedman et al., 1994) with the title “Depression, HIV Dementia, Delirium, Posttraumatic Stress Disorder (or All of the Above).” Comprehensive psychiatric evaluations can provide diagnoses, inform treatment, and mitigate anguish, distress, depression, anxiety, and substance use in persons with HIV and AIDS. Furthermore, thorough and comprehensive assessment is crucial because HIV has an affinity for brain and neural tissue and can cause central nervous system (CNS) complications even in healthy seropositive individuals. Because of potential CNS complications as well as the multiplicity of other severe and complex medical illnesses in persons with HIV and AIDS (Huang et al., 2006), every person who is referred for a psychiatric consultation needs a full biopsychosocial evaluation.

Posttraumatic stress disorder in response to HIV infection

1998 ◽  
Vol 20 (6) ◽  
pp. 345-352 ◽  
Author(s):  
Brian Kelly ◽  
B. Raphael ◽  
F. Judd ◽  
M. Perdices ◽  
G. Kernutt ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Hiv Infection ◽  
Posttraumatic Stress ◽  
Stress Disorder

Epidemiology of Posttraumatic Stress Disorder in Adults

2012 ◽  
pp. 83-97 ◽  
Author(s):  
Naomi Breslau
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Psychiatric Disorders ◽  
Vietnam War ◽  
Posttraumatic Stress ◽  
Vietnam Veterans ◽  
Large Scale ◽  
Stress Disorder ◽  
Future Research ◽  
Specific Response ◽  
Epidemiological Surveys

Posttraumatic stress disorder (PTSD) was established in 1980, when it was incorporated in the DSM-III. The PTSD definition brackets a distinct set of stressors—traumatic events—from other stressful experiences and links it causally with a specific response, the PTSD syndrome. Explicit diagnostic criteria in DSM-III made it feasible to conduct large-scale epidemiological surveys on PTSD and other psychiatric disorders, using structured diagnostic interviews administered by nonclinicians. Epidemiologic research has been expanded from Vietnam veterans, who were the center of DSM-III PTSD study, to civilian populations and postwar regions worldwide. This chapter summarizes information on the prevalence estimates of PTSD in U.S. veterans of the Vietnam War, soldiers returning from deployment in Iraq and Afghanistan, and civilian populations. It outlines research findings on the course of PTSD, risk factors, comorbidity with other psychiatric disorders, and the risk for other posttrauma disoders. It concludes with recommendations for future research.

scholarly journals The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction

2019 ◽  
Vol 13 (4) ◽  
pp. 261-269 ◽  
Author(s):  
Ad de Jongh ◽  
Benedikt L. Amann ◽  
Arne Hofmann ◽  
Derek Farrell ◽  
Christopher W. Lee
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Psychiatric Disorders ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Behavioral Therapy ◽  
Evidence Base ◽  
Primary Diagnosis ◽  
Treatment Intervention ◽  
First Choice ◽  
Emdr Therapy

Given that 2019 marks the 30th anniversary of eye movement desensitization and reprocessing (EMDR) therapy, the purpose of this article is to summarize the current empirical evidence in support of EMDR therapy as an effective treatment intervention for posttraumatic stress disorder (PTSD). Currently, there are more than 30 randomized controlled trials (RCT) demonstrating the effectiveness in patients with this debilitating mental health condition, thus providing a robust evidence base for EMDR therapy as a first-choice treatment for PTSD. Results from several meta-analyses further suggest that EMDR therapy is equally effective as its most important trauma-focused comparator, that is, trauma-focused cognitive behavioral therapy, albeit there are indications from some studies that EMDR therapy might be more efficient and cost-effective. There is emerging evidence showing that EMDR treatment of patients with psychiatric disorders, such as psychosis, in which PTSD is comorbid, is also safe, effective, and efficacious. In addition to future well-crafted RCTs in areas such as combat-related PTSD and psychiatric disorders with comorbid PTSD, RCTs with PTSD as the primary diagnosis remain pivotal in further demonstrating EMDR therapy as a robust treatment intervention.

scholarly journals Epidemiologic Studies of Trauma, Posttraumatic Stress Disorder, and other Psychiatric Disorders

2002 ◽  
Vol 47 (10) ◽  
pp. 923-929 ◽  
Author(s):  
Naomi Breslau
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Psychiatric Disorders ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Epidemiologic Studies ◽  
Community Residents ◽  
History Of ◽  
Dsm Iv ◽  
Definition Of

This paper reviews recent epidemiologic studies of posttraumatic stress disorder (PTSD) in the general population. Estimates of the prevalence of exposure to traumatic events vary with the method used to ascertain trauma exposure and the definition of the stressor criterion. Changes in the DSM-IV definition of “stressor” have increased the number of traumatic events experienced in the community that can be used to diagnose PTSD and thus, the number of PTSD cases. Risk factors for PTSD in adults vary across studies. The 3 factors identified as having relatively uniform effects are 1) preexisting psychiatric disorders, 2) a family history of disorders, and 3) childhood trauma. In civilian populations, women are at a higher risk for PTSD than are men, following exposure to traumatic events. Most community residents have experienced 1 or more PTSD-level traumas in their lifetime, but only a few succumb to PTSD. Trauma victims who do not succumb to PTSD are not at an elevated risk for the subsequent onset of major depression or substance use disorders, compared with unexposed persons.

scholarly journals Constitutional thinness and anorexia nervosa differ on a genomic level

2021 ◽  
Author(s):  
Christopher Hübel ◽  
Mohamed Abdulkadir ◽  
Moritz Herle ◽  
Alish B. Palmos ◽  
Ruth J.F. Loos ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Anorexia Nervosa ◽  
Psychiatric Disorders ◽  
Genetic Correlation ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Genetic Correlations ◽  
Genomic Level ◽  
Increased Risk ◽  
Polygenic Scores

AbstractConstitutional thinness and anorexia nervosa are both characterised by persistent, extremely low weight with body mass indices (BMI) below 18.5 kg/m2. Individuals with anorexia nervosa concurrently show distorted perceptions of their own body and engage in weight-loss behaviours, whereas individuals with constitutional thinness typically wish to gain weight. Both are heritable, share genomics with BMI, but have not been shown to be genetically correlated with each other. We aim to differentiate between constitutional thinness and anorexia nervosa on a genomic level.First, we estimated genetic correlations between constitutional thinness and eleven psychiatric disorders and compared them with anorexia nervosa using publicly available data. Second, we identified individuals with constitutional thinness in the Avon Longitudinal Study of Parents and Children (ALSPAC) by latent class growth analysis of measured BMI from 10 to 24 years (n = 8,505) and assigned polygenic scores for eleven psychiatric disorders and a range of anthropometric traits to evaluate associations.In contrast to anorexia nervosa, attention deficit hyperactivity disorder (rgAN = 0.02 vs. rgCT = −0.24) and alcohol dependence (rgAN = 0.07 vs. rgCT = −0.44) showed a statistically significant negative genetic correlation with constitutional thinness. A higher polygenic score for posttraumatic stress disorder was associated with an increased risk of constitutional thinness in the ALSPAC cohort (OR = 1.27; Q = 0.03) whereas posttraumatic stress disorder shows no genetic correlation with anorexia nervosa (rg = −0.02). Overall, results suggest that constitutional thinness is different from anorexia nervosa on the genomic level.

Metabolic Syndrome and Mental Health in Posttraumatic Stress Disorder Patients

2020 ◽  
Author(s):  
Hassan SHAHMIRI ◽  
Arsia TAGHVA ◽  
Mohammad-Reza EBRAHIMI ◽  
Seyyed Behnam HASHEMI URIMI ◽  
Amir-Mohsen RAHNEJAT
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Posttraumatic Stress Disorder ◽  
Psychiatric Disorders ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Control Group ◽  
Traumatic History ◽  
Psychological Reaction ◽  
Ptsd Group

Abstract Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations such as cardiovascular diseases, diabetes, and metabolic syndrome has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years) and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests.Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders.Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

Trauma and Posttraumatic Stress Disorder—The Special Role in HIV Transmission

2017 ◽  
Author(s):  
Antoine Douaihy ◽  
Melanie Grubisha ◽  
Maureen Lyon ◽  
Mary Ann Cohen
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Posttraumatic Stress ◽  
Partner Violence ◽  
Stress Disorder ◽  
Physical Violence ◽  
Hiv And Aids ◽  
Traumatic Experiences ◽  
People Living With Hiv ◽  
Special Role

The prevalence of posttraumatic stress disorder (PTSD) in persons with HIV is higher than in the general population. Adults with HIV are likely to have experienced traumatic events that place them at risk for developing PTSD. Among women with HIV, PTSD may be more common than depression, suicidality, and substance use. The high prevalence of PTSD is related to increased exposure to traumatic experiences such as physical violence and sexual assault, including intimate partner violence and childhood sexual abuse. The co-occurrence of PTSD and HIV creates complex challenges for both the management of HIV and treatment of PTSD. Individuals with PTSD and HIV experience more rapid illness progression and poorer health-related quality of life, with health-compromising behaviors such as substance use, high-risk sexual behavior, poor utilization of services, and low adherence to antiretroviral therapy. This chapter addresses the complexities of HIV, trauma, and PTSD and recommends trauma-informed care in the treatment of people living with HIV and AIDS.

Sign in / Sign up

Export Citation Format

Share Document