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28 Cards in this Set

  • Front
  • Back
May occur in up to ____ of HIV infected patients
40%
HIV: Suicide is elevated when?
in the weeks or months after HIV antibody testing
AZT, acyclovir, interferon INH and sulfonamides can cause _______ or _________.
depression or delirium
HIV associated conditions that can contribute to depression
chronic pain
headache from HIV encephalitis
peripheral neuropathy
Diagnostic Evaluation should include this when symptoms suggest CNS disorder (headache, focal neuro symptoms, signs of frontal lobe disease)
Imaging studies and screening for cryptococcal disease and syphilis
HIV-1 associated CNS disorders
HIV associated minor cognitive disorder and HIV associated dementia
HIV-1 can directly invade the central nervous system (CNS) T/F
T
HIV associated minor cognitive disorder
may occur in patients who are otherwise asymptomatic or mildly symptomatic. The disorder is characterized by subcortical deficits of attention, information processing speed, learning and memory, and psychomotor skills. May be complicated by the presence of depression or anxiety, but is not caused by psychiatric problems.
HIV Associated Dementia (HAD)
progressive disorder that initially presents as apathy, inertia, cognitive slowing, memory loss, and social withdrawal
As it progresses, multiple cognitive functions become increasingly impaired
The terminal phases are characterized by global cognitive impairment, mutism, and severe psychomotor retardation
When does HAD occur
What is the treatment
usually not until after AIDS develops

Treatment with azidothymidine (Retrovir, AZT, DZV) has been associated with improvement in cognitive functioning
In all acute psychotic disorders you should do this
a magnetic resonance image of the brain and examination of cerebral spinal fluid should be carried out as soon as possible.
Treatment Considerations: Clozapine
contraindicated because of agranulocytosis
Treatment Considerations: olanzapine (Zyprexa)
well-tolerated with few drug interactions and positive studies in HIV+
Treatment Considerations: Quetiapine
contraindicated in combilation with ketoconazole, ritonavir, and macralide antibiotics
Cerebrovascular Accident (Stroke)
They often suffer sudden, multiple loss events

They may lose the neurological capacity to process these loss events

Stroke may affect areas of the brain directly involved in control of mood.
peak incidence of MDD post-stroke
between six months and two years
point prevalence for depression in stroke
between 10-34%
Stroke victems with MDD are less likely to be alive three years following CVA. T/F
T
Risk of MDD and Location of CVA
increases with proximity to the left frontal pole

pallidum (odds ratio 7.2)
Pathological emotionalism is relatively common after stroke, affecting up to ____ of patients in the first six months post-stroke but tending to improve over the following year.
20%
______ of PD patients have MDD
20-40%
MDD can predate motor symptoms of parkinsons by 6 years T/F
T
Onset of depression in parkinsons & AIDS is often is biphasic. What does this mean.
peaks on diagnosis and peaks when symptoms begin to get worse.
Multiple Sclerosis % of MDD
25-40%
drugs for MS that can cause mood changes
steroids
anti-spasticity drugs (including baclofen, dantrolene, and tizanidine)
discontinuation of baclofen and other anti-spasticity drugs
interferon treatment is a risk factor for depression in MS
15% of MS patients die by suicide T/F

Risk factors?
T

Male
young age of onset
previous history of depression, social isolation, and substance abuse
alcohol abuse.
Huntington’s Disease
Inherited disease of movement, cognition and emotion
Behavior changes and personality changes are core symptoms
Depression, irritability, or anxiety is often the first symptom
Myocardial Infarction
20% of patients hospitalized for MI are also suffering from Major Depression
Depression during initial hospitalization is related to poor quality of lif in the first year post-MI
Depression leads to a 3-fold increase in risk of death post-MI
Patients can be effectively treated