PsychEd Episode 57: HIV psychiatry with Dr. Adriana Carvalhal and Dr Leigh Van Den Heuvel

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers HIV/AIDS psychiatry with special guests from two international settings to provide complementary perspectives on HIV psychiatry. Dr. Adriana Carvalhal, HIV Psychiatrist and Staff Psychiatrist at Scarborough Health Network in Canada and Dr. Leigh Van Den Heuvel, Psychiatrist and Associate Professor in the Department of Psychiatry, at Stellenbosch University in South Africa.

The learning objectives for this episode are as follows:

 By the end of this episode, you should be able to…

1. Understand the unique mental health needs of people living with HIV and the bidirectional relationship between HIV and mental health

2. Identify HIV-specific mental health disorders and how to screen for these conditions

3. Outline the overall approach to treatment for HIV patients with mental health disorders

Guests: Dr. Adriana Carvalhal and Dr Leigh Van Den Heuvel

Produced by: Saja Jaberi (MD), Kate Braithwaite (MD) and Gaurav Sharma (PGY5)

Hosts: Kate Braithwaite (MD) and Gaurav Sharma (PGY5)

Audio editing by: Gaurav Sharma (PGY5)

Show notes by: Saja Jaberi (MD) and Gaurav Sharma (PGY5)

Conflicts of Interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Generic names are used for all medications referenced.

Contents:

• Introduction - 0:19

• Learning objectives - 3:52

• The bidirectional relationship between HIV and psychiatric illness - 4:24

• Prevalence of psychiatric illness in HIV - 9:56

• Screening for psychiatric illness in HIV populations - 12:11

• HIV Associated Neurocognitive Disorder (HAND) - 19:27

• Diagnostic Criteria - 20:19

• Clinical Presentation & Etiology - 23:03

• Risk Factors - 26:56

• Screening Tools - 32:06

• Treatment - 36:59

• HIV Psychiatry case example - 39:48

• Navigating the differential diagnosis - 41:44

• Initial management & addressing comorbidities - 44:30

• Drug-drug interactions between antiretroviral and psychiatric medications - 48:04

• Review of learning objectives & final thoughts - 52:04

• Outro - 55:55

 

Resources:

1. Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Ca