Abstract
The management of patients with HIV infection who have comorbidity with psychiatric disorders, is a problem that is encountered relatively frequently in Emergency Departments. This retrospective study aims to evaluate the characteristics of HIV-infected patients who have been admitted for mental disorders and other conditions to an Emergency Department (ED) of Sardinia, Italy, in 2013. Regarding the associated psychiatric condition (25.5 % of total sample) 46.3 % had mood disorders, 38.9 % psychotic disorders and 14.8 % anxiety disorders, with no significant gender differences (p = 0.329). The analysis of the sample showed drug abuse in 29.2 %. A concomitant infection with HBV or HCV was found in the history of almost half of the patients. Only in 24.5 % of cases was there a drug treatment in administered urgently, and an admission to hospital was necessary in 34.3 % of the total sample of patients. Among the admissions, 70.4 % were admitted to a department of infectious diseases, but of these, only 54.4 % had at the admission to the ED signs of acute infection. The management of those who had gained access to emergency services required not only the management of acute disease, but also consideration of which would be the most appropriate department to solve the main problem (infection, fever, agitation, decompensated cirrhosis). Poor patient compliance often makes it difficult to manage, as the analysis of the data shows, a relevant percentage of patients appeared to leave before completion.
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References
Kopnisky KL, Bao J, Lin YW (2007) Neurobiology of HIV, psychiatric and substance abuse comorbidity research: workshop report. Brain Behav Immun 21(4):428–441
Lyketsos CG, Fishman M, Treisman G (1995) Psychiatric issues and emergencies in HIV infection. Emerg Med Clin N Am 13(1):163–177
Ellison JM, Hughes DH, White KA (1989) An emergency psychiatry update. Psychiatric Serv 40(3):250–260
Bennett WM, Joesch J, Mazur M, Roy-Byrne P (2009) Characteristics of HIV-positive patients treated in a psychiatric emergency department. Psychiatric Serv 60(3):398–401
Italian Minister of Health. Accordo tra il Ministro della salute, le Regioni e le Province autonome: “Triage intraospedaliero (valutazione gravità all’ingresso) e chirurgia della mano e microchirurgia nel sistema dell’emergenza-urgenza sanitaria”, 2001, October, 25 (G. U. N. 285, 2001, December, 7th)
SPSS, Inc., Chicago, IL, USA
Chander G, Himelhoch S, Moore RD (2006) Substance abuse and psychiatric disorders in HIV positive patients. Drugs 66(6):769–789
Kelen GD, Green GB, Purcell RH, Chan DW, Qaqish BF, Sivertson KT, Quinn TC (1992) Hepatitis B and hepatitis C in emergency department patients. N Engl J Med 326(21):1399–1404
Altice FL, Kamarulzaman A, Soriano VV, Schechter M, Friedland GH (2010) Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. Lancet 376(9738):367–387
Green JH (1988) Frequent rehospitalization and noncompliance with treatment. Hosp Community Psychiatry 39(9):963
Venkat A, Piontkowsky DM, Cooney RR, Srivastava AK, Suares GA, Heidelberger CP (2008) Care of the HIV-positive patient in the emergency department in the era of highly active antiretroviral therapy. Ann Emerg Med 52(3):274–285
Sternhell PS, Corr MJ (2002) Psychiatric morbidity and adherence to antiretroviral medication in patients with HIV/AIDS. Aust N Z J Psychiatry 36(4):528–533
Dausey DJ, Desai RA (2003) Psychiatric comorbidity and the prevalence of HIV infection in a sample of patients in treatment for substance abuse. J Nerv Ment Dis 191(1):10–17
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52(12):1048–1060
Italian Laws. Legge 13 maggio 1978, n. 180, “Legge Basaglia”
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The authors thank all physicians and nurses of the Emergency Department for their contributions to this study.
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The authors declare no conflicts of interest.
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All human and animal studies have been approved by the appropriate ethics committee and have, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Melis, G., Pia, G., Piras, I. et al. Mental disorders and HIV infection in the emergency department: epidemiology and gender differences. Intern Emerg Med 10, 465–469 (2015). https://doi.org/10.1007/s11739-014-1175-3
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DOI: https://doi.org/10.1007/s11739-014-1175-3