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HIV and Psychiatry / Edition 1

HIV and Psychiatry / Edition 1


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HIV and Psychiatry / Edition 1

Mental health and HIV/AIDS are closely interlinked.  Mentaldisorders, including substance-use disorders, are associated withincreased risk of HIV infection and affect adherence to andefficacy of antiretroviral treatments.  Conversely, HIVinfection can increase risk for neuropsychiatric complicationsincluding stress, mood, and neurocognitive disorders. 

This book provides clinicians with a comprehensive evidenced-basedand practical approach to the management of patients with HIVinfection and co-morbid mental disorders. It provides up-to-dateand clear overviews of current clinical issues, as well as therelevant basic science.  Information and data from studies ofdifferent HIV groups (eg men who have sex with men) make the textrelevant to a broad spectrum of clinicians, including those workingwith low socioeconomic status groups in high income countries andthose working in the developing world.

The book uses the popular format of the World PsychiatricAssociation’s Evidence and Experience series.  Reviewchapters summarize the evidence on the epidemiology, pathogenesisand clinical aspects of mental disorders in HIV,and interventions(both psychotherapy and psychopharmacology including drug-druginteractions).  These are complemented by commentariesaddressing particular facets of each topic and providing insightgained from clinical experience. 

Psychiatrists, psychologists and all mental health staff workingwith HIV-infected patients will find this book of greatbenefit.

Product Details

ISBN-13: 9781118339541
Publisher: Wiley
Publication date: 04/14/2014
Series: WPA Series in Evidence & Experience in Psychiatry Series
Pages: 286
Product dimensions: 6.70(w) x 9.60(h) x 0.80(d)

About the Author

John A. Joska is a Head of the Division of Neuropsychiatryin the Department of Psychiatry and Mental Health at the Universityof Cape Town. He is the Director of the UCT HIV Mental HealthResearch Unit, and the Western Cape Provincial Programme Managerfor HIV Psychiatry. His interests are in HIV and Mental Health,particularly mechanisms of HIV-associated neurocognitive disorders,mental health services, and general neuropsychiatry. John completedboth under- and post-graduate training at UCT. Following completionof his fellowship in psychiatry in 2002, he obtained the Mmed(psychiatry) in 2006, and his PhD in the Neurocognitive Disordersof HIV in 2011. John has been involved in several innovativeresearch projects, including the development of assertive communityoutreach programmes in the Province, and the development of asmartphone application to assist primary health care providers toassess for the presence of dementia. His group was recently fundedto conduct a randomized controlled trial of lithium inHIV-associated dementia. He is excited by the opportunities andchallenges provided by working in Cape Town, South Africa.

Dan J Stein is Professor and Chair of the Dept of Psychiatryand Mental Health at the University of Cape Town, Director of theMedical Research Council (MRC) Unit on Anxiety Disorders, andVisiting Professor of Psychiatry at Mt.  Sinai Medical Schoolin New York.  He is interested in the psychobiology andmanagement of the anxiety, obsessive-compulsive and related, andtraumatic and stress disorders.  He has also mentored work inother areas that are of particular relevance to South Africa andAfrica, including neuroHIV/AIDS and substance use disorders.
Dan did his undergraduate and medical degrees at the University ofCape Town, and his doctorate (in the area of clinical neuroscience)at the University of Stellenbosch.  He trained in psychiatry,and completed a post-doctoral fellowship (in the area ofpsychopharmacology) at Columbia University in New York.  Histraining also includes a doctorate in philosophy.  He isinspired by the way in which psychiatry integrates science andhumanism, and contributes to addressing some of the big questionsposed by life.

Dan's work ranges from basic neuroscience, through clinicalinvestigations and trials, and on to epidemiological andcross-cultural studies.  He is enthusiastic about thepossibility of clinical practice and scientific research thatintegrates theoretical concepts and empirical data across thesedifferent levels.  Having worked for many years in SouthAfrica, he is also enthusiastic about establishing integrativeapproaches to services, training, and research in the context of alow and-middle-income country.

Table of Contents

List of Contributors ix

Preface xv

1 Epidemiology of Psychopathology in HIV 1
Milton L. Wainberg, Karen McKinnon, and FrancineCournos


1.1 Epidemiology of Psychopathology in HIV: NeurocognitiveDisorders 34
Bryan Smith and Ned Sacktor

1.2 Depression and Anxiety Disorders in HIV/AIDS 40
Seggane Musisi

1.3 Substance Use Disorders and HIV: Evolving Syndemics 46
Sheri L. Towe and Christina S. Meade

1.4 Severe Mental Illness and HIV 55
Etheldreda Nakimuli-Mpungu

2 Pathogenesis of Mental Health Disorders in HIV 61
Gursharan Chana, Chad A. Bousman, and Ian P. Everall


2.1 Behavioural and Social Risk Factors for HIV 82
Landon Myer

2.2 Brain Imaging and Neuro-HIV 87
Christine Fennema-Notestine

2.3 Host Genetics in HIV-Associated Neurocognitive Disorders93
Avindra Nath and Wenxue Li

2.4 Traumatic Stressors and the Psychoneuroimmunology of HIV/AIDS99
Dan J. Stein, John A. Joska, and Kathleen J. Sikkema

3 Clinical Aspects of HIV-Related Neurocognitive Disorders107
Nicholas W.S. Davies and Bruce J. Brew


3.1 Clinical Aspects of HIV-Related Neurocognitive Disorders131
Robert Paul and Jodi Heaps

3.2 Differential Diagnosis in HIV-Associated NeurocognitiveDisorders 137
Gabriele Arendt

3.3 Psychiatric Disorders and HIV 143
Glenn Treisman

3.4 Optimizing the Effectiveness of HIV Treatment as Preventionwith Stimulant Users 149
Adam W. Carrico

4 Treatment of Psychiatric Disorders in HIV 157
Maria Ferrara, Ignacio P. Valero, David J. Moore, Adam F.Knight, Nichole A. Duarte, and J. Hampton Atkinson


4.1 Combination Anti-Retroviral Treatment and NeuroHIV 194
Charles Venuto and Giovanni Schifitto

4.2 Psychopharmacology and Psychiatric Co-morbidity 199
Mark Halman

4.3 Intervention in HIV and Psychiatry: Behavioural andPsychotherapeutic Approaches 205
Reuben N. Robbins and Robert H. Remien

5 Special Populations and Public Health Aspects 211
Francine Cournos, Karen McKinnon, Veronica Pinho, and MiltonWainberg


5.1 Mental Health Services for HIV in Resource-Limited Settings235
Crick Lund

5.2 Specifying the Mental Health Context for the Development of HIVPrevention and Treatment Interventions for Men Who Have Sex withMen 240
Jessica F. Magidson and Conall O’Cleirigh

5.3 Following the Special Populations Home: Children and Families245
Lucie Cluver, Mark Boyes, Mark Orkin, Lorraine Sherr, and MalegaKganakga

5.4 Gender Issues and the Burden of Disease in Women 256
Catherine Mathews and Naeemah Abrahams

Index 263

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