It is generally accepted that the first building block of modern psychiatric nosology was Kraepelin’s distinction between those disorders we now know as mood disorders and the illness (or illnesses) we…

Figure 2­1 depicts an integrative schema that conceptualizes the interplay of extrinsic and intrinsic factors with the schizophrenia diathesis. The basis for this formulation is the familiar stress-diathesis model…

An appropriate treatment approach to depression begins with a consideration of the differential diagnostic possibilities outlined earlier in this chapter. Obviously, since there are no available biological tests (except for the medical/organic conditions), or even…

More than two dozen studies have been published examining the rates of occurrence of depression in the course of schizophrenia (Koreen et al. 1993; Sands and Harrow 1999;…

Introduction
Among the chronic health conditions experienced by people with schizophrenia, infection with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) occurs with notable frequency. People who…

HIV-related psychopharmacological interventions for people with preexisting schizophrenia follow similar guidelines for patients with new-onset psychosis associated with HIV infection. In advanced HIV infection, traditional neuroleptic agents have…

Mental health service settings vary in their ability to offer HIV-related interventions, and the range of services available may not yet be meeting the needs of people…

Risk Reduction Interventions and Strategies for HIV/HCV
HIV prevention programs that primarily dispense AIDS information have not been shown to influence risk behavior levels because, as evidence from studies demonstrates, knowledge by itself is…

Diagnostic testing to determine the presence of HCV viremia and the extent of liver pathology should be completed as early as possible in the care of a patient infected with HCV. Liver biopsy is useful…

Given preliminary estimates that one in five patients with severe mental illness is infected with HCV, a strong argument can be made that all such persons should be screened for the virus. Certainly,…

Clinical management is intended to decrease viral load, increase CD4 cell count, provide prophylaxis against OIs as appropriate, treat OIs when present, and decrease morbidity and mortality. New knowledge about the life cycle of HIV…

HIV targets host CD4 T lymphocytes by identifying certain surface molecules and attaching to and entering the cells (Staprans and Feinberg 1997). This begins the process of using the viral reverse transcriptase…

Although HIV has been isolated from a variety of body fluids, including blood, semen, vaginal secretions, breast milk, urine, saliva, and tears, the risk of transmission is a consequence of the amount of virus present…

Approximately 940,000 persons in North America and about 40 million persons worldwide are infected with HIV. Infection with HIV is a chronic disease that normally runs its…

AIDS is the ultimate result of HIV infection, and knowledge about AIDSrelated issues among United States and Canadian psychiatric patients appears to be relatively good compared…

Substance Use Risk Behaviors Among People With Schizophrenia and Their Association With Psychiatric and Situational Factors

In the United States, psychiatric patients with identified comorbid alcohol or other drug…

Sexual Risk Behaviors Among People With Schizophrenia and Their Association With Psychiatric and Situational Factors

Most studies of sexual risk behavior among people with psychiatric disorders have not linked behaviors…

Obesity is a complex multifactorial chronic disease that develops from the interaction between genotype and the environment. Obesity in individuals with mental disorders such as schizophrenia has been attributed to various factors, including…

In the pre-antipsychotic era, Kraepelin noted that some patients with schizophrenia exhibited bizarre eating habits, and not uncommonly were obese. “The taking of food fluctuates from complete refusal to the greatest voracity. The body…

The literature thus far suggests that some of the novel antipsychotic medications cause less weight gain than others; thus it may be possible to switch patients on agents associated with the…

Behavioral interventions such as calorie restriction, exercise, and behavioral modification are key elements to successful, sustained weight loss (NHLBI 2000; NHLBI also has posted on its Web site a practical guide for obesity evaluation and…

The effects of antipsychotic-related weight gain have both medical and psychiatric components. In particular, medication compliance is adversely affected by excessive weight gain, with weight gain being a wellknown cause of treatment nonadherence…

Novel antipsychotic medications and conventional antipsychotic medications affect a number of central neurotransmitter systems that may have an impact on satiety and feeding behavior. Many of the receptor systems blocked by antipsychotic medications…

Obesity and its related sequelae represent a growing epidemic in the United States. Overweight is defined by the World Health Organization as a body mass index (BMI) of 25.0­29.9 kg/m², and obesity as…