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HIV testing is not yet a routine procedure in most mental health settings although adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS.
We focused our attention to explore if the appropriate care of patients with SMI may include a routine HIV testing offering and thus contribute to diagnose HIV-infected persons earlier in the course of their infection.
We present three case histories related to primary HIV diagnosis in patients presenting with different psychiatric disorders, admitted to Modena teaching Hospital in the passed two years.
Psychiatric symptoms delayed HIV diagnosis in all of the three reported cases.
The case histories here presented suggest that HIV testing is appropriate in the care of people with SMI, avoiding delay in HIV diagnosis with an obvious clinical benefit for the patient. Further studies are needed to assess the prevalence of HIV in those patients. These will be able to validate psychiatric diseases within a specific HIV indicator diseases list and help identifying a segment of the population in which HIV test must be routinely offered as a public health strategy, to face the burden of undiagnosed HIV infection.
In a demographic survey in 2005, 13.6% of Italians admitted to have taken CAMs during the 3 years before. A study on hospitalized patients for psychiatric reasons highlighted that 63% of them used CAM in the previous year and 79% did not mention this to their psychiatrists.
To collect the opinions about the use of CAMs in psychiatry among a group of psychiatrists and nurses working in a Mental Health Centre.
To investigate knowledge, opinions and experiences on CAMs.
A mixed qualitative-quantitative method was used: 2 focus groups were conducted in June 2011, involving 12 professionals of one Mental Health Community Centre in Modena, Italy. The audio-recordings of the focus groups were analyzed by 2 researchers, who identified the main themes with an inductive method. The participants were finally asked to fill in a respondent validation questionnaire.
Four main themes were developed:
1) advantages, and
2) disadvantages in the use of CAMs,
3) patients’ and own experiences,
4) variety of therapies under the CAM acronym.
Among the pros, 75% of respondents agreed that CAMs allow a better global approach to the patient, 58% that CAMs may improve quality of life, 66% that conventional psychiatric therapies do not solve every situation. As to disadvantages, some professionals (medical doctors) expressed skepticism on CAMs.
Being realistic, open-minded and ready to listen and cooperate: this could be the best attitude towards patients who take CAMs.
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