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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
close this folderCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
View the document11.1 Neurological complications with secondary mental manifestations
View the document11.2 Changes in mental status - Delirium (acute organic brain syndrome)
View the document11.3 Changes in mental status - AIDS related dementia (ADC) (chronic organic brain syndrome)
View the document11.4 Changes in mental status - AIDS Related Mania
Open this folder and view contents11.5 Mental complications
View the document11.6 Crisis and crisis counseling
View the document11.7 Persons with previous mental disorders
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

CHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS

As in any chronic illness, mental health problems are often found in HIV-positive persons. Any change in mental state, either acute or chronic, must be evaluated immediately in order to determine if it arises from a pre-existing medical or mental disorder or if it is caused by HIV or an OI. ART drug side effects or systemic illness can also result in changes in mental health status. When patients present with altered mental health status, they should be evaluated for drug side effects and systemic illnesses as a result of conditions that have already been mentioned elsewhere. These include hypoxia, sepsis, uremia, acid base disturbances, hepatic encephalopathy etc.

Changes in mental health status can be the result of neurological or mental complications of HIV and/or AIDS. For purposes of clarity a distinction is made between symptoms that are a result of:

Primary neurological complications with secondary mental manifestations

• Focal neurological changes suggestive of a mass lesion (acute organic brain syndrome)
• Meningitis (acute organic brain syndrome)
• Non-focal or global mental status changes (chronic organic brain syndromes)
• AIDS related mania


Primary mental complications

• Adjustment disorders
• Depression
• Anxiety disorders
• Substance abuse disorders
• AIDS related mania


A diagnostic approach based on clinical presentation should be used to successfully approach neurological and mental complications of AIDS in settings where expensive investigations such a brain scans and magnetic resonance imaging may not be available. The aim would be to determine if the presentation represents:

• Focal neurological changes suggestive of a mass lesion
• Meningitis (acute organic brain syndromes)
• Global mental status changes (chronic organic brain syndromes) or
• Primary mental complications

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