Despite the fact that people living with HIV/Aids (PLWHA) face an increased risk of developing mental health conditions, these conditions are treatable and, with help, the patient can recover, said Dr Aneshree Moodley, consultant specialist at Akeso Psychiatric Clinics.
Due to the virus’ tendency to replicate in the central nervous tissue, HIV/Aids may not only cause direct physiological injury to brain matter and neurological pathways, thereby leading to neurocognitive disorders, a multitude of psychological and social consequences of living with HIV/Aids may lead to a variety of mental disorders, she added. These include:
• Apathy: Initially apathy may be subtle and consequently be mistaken for laziness or tiredness.
• Psychosis: HIV-associated dementia (HAD) often occurs in the context of mania. HIV is a biological stress on the body. In addition, the anxiety of having a life-threatening disease brings immense psychological stress.
• Delirium: This is a very important and common neurocognitive presentation with a point prevalence of 30 – 40 per cent among hospitalised HIV positive patients. ”It is important for anyone suspected of having delirium to urgently present themselves to the nearest emergency room where qualified medical personal can complete a comprehensive physical evaluation and investigations to distinguish delirium from HANDS, or schizophrenia and other mental disorders and thereby commence correct treatment,” Dr Moodley stressed.
• Depression: Depression in HIV/Aids is a complex matter. “Psychosocial factors such as adjusting to the diagnosis, making meaning of a positive diagnosis, receiving news of the disease’s progression, adapting to life with a chronic life-threatening illness and living through the decompensation and death of family/friends from HIV, contribute immense psychological stress which increase one’s risk of depression.
“In addition, the neurological impact of the virus at a biological level within the brain pathways may also increase risk of depression. A national study completed in 2001 in the USA, revealed a 36 per cent one-year prevalence of depression among HIV positive people. Another US meta-analysis revealed that depression occurs twice as often in HIV positive people than HIV negative people.”
Due to the emotional and psychological implications of having HIV, one must be aware of the risk of mental illness and look at strengthening one’s social network and support systems, advised Dr Moodley.
“There is strong evidence that family support plays a significant protective role for mental illness co-occurring in the context of HIV. It is important to encourage open and honest conversations among family members and eradicate the attitude of denial and silence. It is also important to raise awareness of available counselling and support programmes which may benefit the infected person or their families,” Dr Moodley concluded.
Details: Akeso Clinics, www.akeso.co.za or 011 447 0268.
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