Venkatesh, Mathan Kumar (2008) Comparative study of Psychiatric Morbidity among HIV Positive patients and Leprosy patients. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: AIDS has become a great and powerful symbol for a world threatened By its divisions. In a deep and remarkable way, the child with AIDS is the World’s child, the man or woman dying of AIDS has become the world’s image Of our own mortality. Jonathan Mann Director Global programme on AIDS, WHO Infection with Human Immunodeficiency Virus (HIV) and its end stage, Acquired Immunodeficiency Syndrome (AIDS) is the major public health Challenge of our times, with over 25 million persons already dead and over 50 Million living with HIV/AIDS, the majority of whom, without access to Therapy. AIDS was first recognized in the US in 1981 with reports of Unexplained opportunistic infections, including Pneumocystis jirovecii (formerly Pneumocystis carinii), pneumonia and Kaposi’s Sarcoma (KS) Among homosexual men in New York and San Francisco (Cleghorn, Reitzfr, And Gallo; 2000). The first case of HIV infection in India was diagnosed among Commercial sex workers in Chennai, Tamil Nadu, 1986. HIV / AIDS is a major public health problem all over the world. The Overwhelming majority of HIV infected people, more than 90%, live in the Developing world and most of them do not even know that they are infected. This epidemic killed about 3 million people all over the world in the year 2004. Globally more than 40 million people are infected with HIV (Training Module On continuum of care for health care provider 2005 TNAIDS control society). According to the HIV sentinel surveillance report 2005, an estimated 5.206 million people in India were infected with HIV. Out of the total HIV Infection 38.4% were females; 57% lived in the rural areas. (HIV & AIDS Epidemiological surveillance & estimation report for the year 2005) Psychiatric disorders, including mood disorders, anxiety disorders, Substance use disorders, cognitive disorders, personality disorders, psychotic Disorders and delirium are highly prevalent among patients infected with HIV. Psychopathology may have impact on treatment adherence, quality of life, Social and adaptive functioning and possibly HIV – illness progression (Robinson and Quaqish 2002). During the course of illness, upto 85% of HIV – Seropositive individuals report some depressive symptoms and upto 50% Experience major depressive disorder. In a metaanalysis of published studies, Ciesla and Robert (2001) found that people with HIV were almost twice as Likely as those who are HIV – Seronegative to be diagnosed with major Depressive disorder and that depression was equally prevalent in people with Both symptomatic and asymptomatic HIV. Life time prevalence rates of Anxiety disorders are higher in the HIV clinical population as a whole than in The general population (Blalock et al 2005). Initial symptoms of HIV infection Are neuropsychological in 10% to 30% of cases (Lezak – 1995). LEPROSY The first description of Leprosy came from India about 600 BC. The Disease was called Kushta and was described as being different from vitiligo. The origin of leprosy is, however, still a mystery, and some recent Evaluations pointed out that Mycobacterium leprae, the etiological Microorganism, is a degenerative mycobacterium that came in contact with Humans when the first farmer settled in the Middle East, Europe and Asia Thousands of years ago (Young, D.Robertson, et al, 2001). Leprosy is also known as Hansen’s disease, after demonstration of Mycobacterium leprae by Gerhard Amauer Hansen in 1873(Hansen,Galooft,1895). The lesions of leprosy predominantly affect the skin, nasal mucosa and Peripheral and superficial nerves. This is because Mycobacterium leprae grows Best in cooler tissues. Estimates of the total number of cases of leprosy worldwide vary from 8 Million – 10 million. Most of the cases are in South East Asia, especially in India (10 cases per 1000 inhabitants) and in sub- Saharan Africa, where the Disease reaches high endemic level (>40 cases per 1000 inhabitants). Leprosy Affects males more frequently than females in a ratio of 2:1. Socioeconomic Factors play an important role in leprosy around the world and account for the Failure of imported cases to produce Secondary cases in Europe and United States. Although Leprosy is a chronic infectious disease, it may be considered An immunological disease to a great extent, partially explaining the differing Clinical pattern. Two different classifications are used - the Madrid Classification (International congress of leprosy, 1966), accurate for clinical Evaluation of leprosy patients, and the Ridley – Jopling classification useful for Immunological classification. According to the Madrid classification, leprosy Can be subdivided into 4 different types; Lepromatous, Tuberculoid, Borderline And Indeterminate forms. For the treatment of a large population, patients may be divided into Paucibacillary cases (Tuberculoid and Indeterminate leprosy) and Multibacillary (Lepromatous and Borderline leprosy). The clinical manifestations of leprosy vary from hypopigmented Macules to widespread damage to peripheral nerves, skin, eyes and bones Leading to deformity and disability. Leprosy is still a major public health problem in India, even though the Prevalence rates have come down from 57.6 cases per 10,000 population (1981) to 2.7 cases per 10,000 population (September 2003) (Dhilion et al ). Reduction in prevalence rate alone, however, is not sufficient because, the Social consequence of the disease on the life of patients is often severe and Persists even after its cure (Santosh K. Chaturvede et al).
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Psychiatric Morbidity ; HIV Positive patients ; Leprosy patients. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 19 Aug 2017 03:25 |
| Last Modified: | 19 Aug 2017 03:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2007 |
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