Background:Nowadays, sleep-related problems are a prevalent occurrence among university students. Poor sleep quality is one of the most studied aspects of sleep complaints, affecting from 10% to 50% of this population. Poor sleep quality consequences are many and have a profound impact in the student's psychobiological health. University students live through a period of psychological challenge and adaptation, since the transition from high school to professional life. Abrupt autonomy challenges students to deal with many choices, from their academic and social life to their intimate habits. Frequently, sleep hygiene is neglected, or they are unable to use proper coping mechanisms, resulting in disturbing consequences that could impact their lives as adults. Research has found a significant association between sleep quality and depression or depressive symptoms, but this relationship is still somewhat difficult to interpret.Objective:The objective of this review is to appraise the current knowledge around the relationship of sleep with depression in this group of young adults. Data Source: Articles included in Medline database.Methods:After a careful search, the articles selected aimed mainly college students. The studies had sleep quality and depression objectively assessed, focused in the relationship between both, and addressed possible influencing factors.Results:The current literature still supports a bidirectional relationship between sleep and depression, however, the importance of sleep quality is becoming a very relevant variable.Conclusion:Education and the application of policies regarding sleep hygiene may prevent, in some cases, the development of depression and improve the quality of sleep in other cases. Future research should clarify the relationship between sleep problems and depression in a way they could be prevented or, at least, minimalized with effective and achievable interventions.

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This study focused on neurocognitive disorders associated with HIV infection, characterizes the most affected neuropsychological domains and their potential as factors related with depression. 130 HIV-positive individuals with CD4 [200 cells/mm 3 , undetectable viral load, treated with HAART and with all kinds of risk behaviors were included. A structured interview composed by seven sections was used and relevant clinical and laboratory data was assessed. For the neuropsychological and depression assessment the HIV Neurobehavioral Research Center (HNRC) Battery and Hamilton Rating Scale for Depression (HAM-D) were chosen. Univariate nonparametric statistics and multivariate regression model were performed. Among 34% of depressed subjects, 20.7% had attempted suicide, 45.4% were under psychiatric medication and only 19% had no diagnostic criteria for HIV Associated Neurocognitive Disorders (HAND). The effect of depression on cognitive function revealed a significant deterioration in five of the eight measures. In the multivariate analysis, five variables significantly determined depression: sex, social class, antidepressant medication, history of suicide attempt and Dexterity and motor speed (neuropsychological test battery). Despite good patient adherence to treatment (HAART and antidepressive) and good immune status, the prevalence of HAND and depression are high and suggest a significant relation between severity of depression and cognitive functioning.Resumen Este estudio se centra en los trastornos neurocognitivos asociados a la infección por el VIH, caracteriza los dominios neuropsicológicos más afectados y su potencial relación con la depresión. Fueron incluidos en el estudio 130 individuos VIH-positivos con CD4[200 células/mm 3 , carga viral indetectable, medicados con HAART abarcando todos los comportamientos de riesgo. Fue utilizada una entrevista estructurada compuesta por siete secciones y se evaluaron los datos clínicos y de laboratorio. Para la evaluación neuropsicológica y la depresión fueron elegidas la batería de lo HNRC (HIV Neurobehavioral Research Center) y la Escala de Hamilton para Depresión (HAM-D). Se utilizaran estadísticas univariantes no paramétricas y el modelo de regresión multivariante. Entre el 34% de los sujetos deprimidos, el 20,7% había intentado suicidarse, el 45,4% hacían medicación psiquiátrica, y sólo el 19% carecía de criterios para el diagnóstico trastornos neurocognitivos asociado al VIH (HAND). El efecto de la depresión sobre la función cognitiva revela un deterioro significativo en cinco de las ocho medidas. En el análisis multivariado, cinco variables se asocian significativamente con la depresión: el sexo, la clase social, los medicamentos antidepresivos, la historia de intentos de suicidio y la destreza y velocidad motora (batería neuropsicológica). A pesar de buena adherencia de los pacientes al tratamiento (HAART y antidepresivos) y del buen estado inmunológico, la prevalencia de HAND y depresión son altas y sugieren una relación significativa entre la gravedad de la...

Objectives We aimed to describe and correlate the hospital panorama of psychotic disorders (PD) with cannabis use (CU) trends in all Portuguese public hospitals. Methods We conducted a retrospective observational study that analysed all hospitalizations that occurred in Portuguese public hospitals from 2000 to 2015. Hospitalizations with a primary diagnosis of PD or schizophrenia were selected based on Clinical Classification Software diagnostic single‐level 659. Episodes associated with CU were identified by the International Classification of Diseases Version 9, Clinical Modification code 304.3/305.2 that correspond to cannabis dependence/cannabis abuse. Results The number of hospitalizations with a primary diagnosis of PD and schizophrenia associated with CU rose 29.4 times during the study period, from 20 to 588 hospitalizations yearly (2000 and 2015, respectively) with a total of 3,233 hospitalizations and an average episode cost of €3,500. Male patients represented 89.8% of all episodes, and the mean/median age at discharge were 30.66/29.00 years, respectively. From all hospitalizations with a primary diagnosis of PD or schizophrenia, the ones with a secondary diagnosis of CU rose from 0.87% in 2000 to 10.60% in 2015. Conclusions The increase on secondary diagnosis coding and the change on cannabis patterns of consumption in Portuguese population with an increasing frequency of moderate/high dosage cannabis consumers may explain the rise on PD hospitalizations.

The aim of our study was to evaluate the impact of coffee intake on cognitive function in persons living with HIV (PLWH). 130 PLWH with CD4 > 200 cells/mm(3), undetectable viral load, treated with HAART were included. A structured interview was applied and relevant clinical and laboratory data were assessed, including coffee intake. For neuropsychological assessment, the HIV Neurobehavioral Research Center Battery was chosen. Univariate nonparametric statistics and multivariate regression model were used. A significant association between espresso coffee use and a better cognitive function was verified in five of the eight psychometric measurements. In the multivariate analysis, after variable adjustment, linear regression analysis showed that coffee intake was a positive predictor for attention/working memory, executive functions and Global Deficit Score. Although the mechanisms behind the influence of caffeine on cognitive functioning are controversial, regular espresso coffee intake may have favourable effects on cognitive deterioration caused by HIV.

IntroductionManagement of HIV/AIDS “worried well” people is among the most complex and challenging psychiatric problems in HIV care.ObjectivesTo provide an overview of HIV/AIDS “worried well”.MethodsLiterature review based on PubMed/Medline, using the keywords “HIV” and “worried well”.ResultsThe HIV/AIDS “worried well” are those individuals who are intensely worried about being infected with HIV, despite overwhelming evidence to the contrary. Indeed, they will rapidly return with the renewed conviction that the physician has “got it wrong” or “missed something”. So, they tend to over-utilize health care services. Seven HIV/AIDS “worried well” sub-groups have been identified: those with past sex or drug use history; those with relationship problems; the partners/spouse of those at risk; couples in individual or family life transitions; past history of psychological problems; misunderstanding of health education material; and pseudo and factitious AIDS. These patients have several striking consistencies in their presenting phenomenology and background features and usually have psychiatric problems associated. The authors will analyze all these aspects. Currently there are no guidelines to deal with this clinical condition, however cognitive-behavioral therapy along with selective serotonin reuptake inhibitors has been an effective approach. It is also important to ensure follow-up discussion to these patients, especially where unresolved life issues may cause future vulnerability in absence of intervention.ConclusionsPatients may express their concerns about HIV infection by several ways, directly or indirectly, and psychiatrists need to be aware of this reality, which causes much suffering as well as severe monetary loss.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionMania occurs in higher rates among individuals with HIV/AIDS, especially with the progression of HIV infection, and constitutes an additional risk factor for facilitate the HIV spread.ObjectiveTo provide an overview of secondary mania in HIV-infected patients.MethodsLiterature review based on PubMed/Medline, using the keywords “HIV”, “AIDS” and “mania”.ResultsSecondary mania or AIDS mania may be due to illicit or prescribed drugs, CNS infection with HIV, medical illness, including opportunistic infections. Of these, HIV neurotoxicity has been proposed to be the most important factor in its pathogenesis. Mania AIDS differs from primary mania with regard to clinical presentation, course, management and prognosis. The authors will analyze them. Besides decrease to treatment adherence, maniac symptoms also predispose to HIV risk behaviors, which may lead to further HIV transmission. Importantly, the occurrence of HIV mania may announce the transition from HIV infection to AIDS perhaps before other clinical signs are evident. Early recognition and treatment of manic symptoms with mood stabilisers, antipsychotics and HAART improve quality of life, protect from further cognitive deterioration and decrease mortality. In these patients, medication side-effects toxicity, drug interactions, and adherence require special attention.ConclusionsMania has been associated with HIV/AIDS and in many instances acts as a barrier to achieving best treatment outcomes. Thus, psychiatrists need to be aware of the complexities involved in the emergence of manic episodes in HIV-infected patients in order to deal with them in the most appropriate and effective manner.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionPsychosis represents an uncommon but serious complication in the course of HIV infection, and always requires a careful differential diagnosis.ObjectivesTo provide an overview of psychosis in HIV-infected patients.MethodsLiterature review based on PubMed/MEDLINE, using the keywords “HIV” and “psychosis”.ResultsPsychosis in HIV-positive individuals can be divided into psychotic disorders predating HIV infection and new-onset psychotic disorders in HIV-seropositive patients. The pathophysiology of psychosis in this population is complex and a multifactorial etiology is likely in most instances. The authors will analyze them and describe the differences of psychopathological pattern in first-episode psychosis between HIV-positive and HIV-negative patients. Antipsychotic agents are the treatments of choice regardless of the underlying diagnosis. However, they should always be used at the lowest possible dose for the shortest possible duration. Increased sensitivity to extrapyramidal reactions, high risk for dyslipidemia and hyperglycemia, potential interactions between HAART and some antipsychotic agents are also important considerations. Importantly, psychosis may be a harbinger of dementia. Cross-sectional studies have also suggested that psychosis may adversely impact the morbidity and mortality associated with HIV-infection.ConclusionsPsychosis disorders may arise before or at any time during the course of HIV infection. A solid understanding of the complex relationship between psychosis and HIV allows for better evaluation and more effective treatment for psychotic individuals at risk for or infected with HIV. Thus, both HIV care programs and psychiatric care clinics should be made familiar with this important subject.Disclosure of interestThe authors have not supplied their declaration of competing interest.