Infection à VIH et trouble bipolaire : quels enjeux cliniques et thérapeutiques ?

Abstract : Bipolar disorder (BD) is a severe mental illness that causes unusual changes in mood. Hypersexuality during manic phases and addictive comorbidities may be risky behavior. We hypothesized that patients with BD may be at risk of HIV infection. These pathologies are most stigmatized worldwide. It may be thought that patients with BD and HIV experience the phenomenon of stigmatization cumulatively. In addition, the therapeutic management of these patients seems to be complex. We have been able to demonstrate that patients with BD are at higher risk for HIV infection. Although the studies are few in number, some have a large sample of patients and show that the prevalence of HIV in patients with BD is higher than in the general population and vice versa. In patients with BD, we have seen that hypersexuality during manic episodes can lead to sexual risk behaviors. In addition, concomitant substance use disorders also lead to an increase in risky sexual behaviors. Management is complex because of drug interactions, side effects of treatment and compliance difficulties. Through this study we show that HIV can be a comorbidity of BD that probably increases the phenomenon of stigmatization. Preventive actions in patients suffering from BD seem necessary as well as a reinforcement of screening. The management of addictive comorbidities also seems to be a major issue. New actions are needed to facilitate access to care for patients with BD and HIV. This will reduce the risk of non-compliance due to their psychiatric symptoms and stigma, limit the risk of transmission and improve their quality of life and care.
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Master Thesis
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Submitted on : Friday, March 22, 2019 - 3:53:29 PM
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Lola Tirole. Infection à VIH et trouble bipolaire : quels enjeux cliniques et thérapeutiques ?. Médecine humaine et pathologie. 2018. ⟨dumas-02077046⟩

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