Mental disorders and HIV infection in the emergency department: epidemiology and gender differences

The management of patients with HIV infection who have comorbidity with psychiatric disorders, is a problem that is encountered relatively frequently in Emergency Departments. This retrospective study aims to evaluate the characteristics of HIV-infected patients who have been admitted for mental disorders and other conditions to an Emergency Department (ED) of Sardinia, Italy, in 2013. Regarding the associated psychiatric condition (25.5 % of total sample) 46.3 % had mood disorders, 38.9 % psychotic disorders and 14.8 % anxiety disorders, with no significant gender differences ( p = 0.329). The analysis of the sample showed drug abuse in 29.2 %. A concomitant infection with HBV or HCV was found in the history of almost half of the patients. Only in 24.5 % of cases was there a drug treatment in administered urgently, and an admission to hospital was necessary in 34.3 % of the total sample of patients. Among the admissions, 70.4 % were admitted to a department of infectious diseases, but of these, only 54.4 % had at the admission to the ED signs of acute infection. The management of those who had gained access to emergency services required not only the management of acute disease, but also consideration of which would be the most appropriate department to solve the main problem (infection, fever, agitation, decompensated cirrhosis). Poor patient compliance often makes it difficult to manage, as the analysis of the data shows, a relevant percentage of patients appeared to leave before completion.