Dergi Ara >>
Yıl:2005; Cilt: 18; Sayı: 3>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2005;18(3):149-156
HIV ile Enfekte Hastalarda Gözlenen Psikiyatrik Bozukluklar
B Bakım, B Özçelik, KO Karamustafalıoğlu
Şişli Etfal Eğitim ve Araştırma Hastanesi Psikiyatri Kliniği, İstanbul
AIDS'li hastaların çoğunluğu homoseksüel erkekler ve intravenöz drog kullanıcılarıdır. HIV ile enfekte kişilerde uyum bozuklukları, depresif bozukluklar, anksiyete bozuklukları, kişilik bozuklukları, bipolar bozukluk, uyku bozuklukları, alkol-madde kötüye kullanım bozukluğu, deliryum, demons ve psikoz şeklinde çoğu psikiyatrik sendrom gözlenebilmektedir. HIV, fırsatçı enfeksiyonlar, anti-HIV tedavileri ve HIV hastalığındaki psikososyal stres etmenleri tüm hastalık seyri boyunca psikiyatrik morbiditeye yol açar. Demans ya da bilişsel bozukluğun hafif şekilleri HIV enfeksiyonunun önemli sonuçları olan önemli gö¬rünümlerinden biridir. Erken belirlenmesi ve tedavisi hastalığın ilerleyişini önlemede asaldır. Bitkinlik ve depresyon belirti¬leri HIV enfeksiyonunda yaygın olarak görülmektedir. HIV ile yaşamakta olan kişilerde depresyon hayat kalitesine belirgin etkiler yapmakta, HIV hastalığının ilerlemesi, kötü anti-HIV tedavi uyumu ve intihar riski sebebiyle önemlidir. Kişilik bozuk¬lukları HIV pozitif kişilerde yaygın olarak gözlenebilmektedir. Anksiyete belirtileri belirgin stres altında bu hasta grubunda yaygın olarak gözlenmekte olup, major anksiyete bozuklukları genel nüfusla aynı sıklıkta gözlenmektedir. Alkol ve madde kullanım bozuklukları HIV riski olan bireylerde yaygın görülmektedir. Psikiyatrik bozukluklar sıklıkla HIV enfeksiyonu ve tedavisinden önce gelmektedir, enfeksiyon ve tedaviden bağımsızdır. AİDS hastaları yüksek suisid oranlarına sahiptir, intihar riski olan hastalar, bu riski taşıyan diğer hastalar gibi psikolojik ve sosyal destek gerektirirler.
Psychiatric Disorders Among Patients with HIV Infection
Most of the patients with AIDS are homosexual men or intravenous drug users. HIV infected individuals are subject to the full range of psychiatric syndromes including adjusment disorders, depressive disorders, anxiety disorders, personality disorders, bipolar disorders, sleep disorders, alcohol-substance related disorders, delirium, dementia and psychoses. HIV, opportunistic infections, anti-HIV medications, and the psychosocial stress of HIV illness cause substantial psychiatric morbidity over the course of illness. Dementia or milder forms of cognitive impairment are important manifestations of HIV infection with important consequences. Early detection and treatment is essential to prevent progression. Fatigue and depressive symptoms are common in HPV infection. Depression has a significant impact on the quality of life of persons living with HIV and is associated with HP/ disease progression and mortality, either poor adherence with antiretroviral regiments or risk for suicide. Personality disorder is also common in the HIV- positive population. Symptoms of anxiety are very common in this patient population under substantial stress, while major anxiety disorders appear to occur with the same frequency as in the general population. Alcohol and substance abuse disorders are common in individuals across HP/ risk factors. Psychiatric disorders often predate and are independent problems that interact with HIV infection and treatment. Patients with AIDS have an elevated rate of suicide. This suicidal patients require the same psychological and social support as other persons at risk for suicide.

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