APM AIDS Psychiatry Special Interest Group

Welcome to the APM AIDS Psychiatry SIG, formerly known as the Organization of AIDS Psychiatry (OAP). Now in its 9th year, the group was founded in 2003 by Mary Ann Cohen, MD, FAPM to support mental health clinicians who provide care for persons with HIV and AIDS. In 2011, Kelly L. Cozza, MD, FAPM accepted Dr. Cohen's invitation to serve as co-chair of the SIG.

We welcome psychiatrists and other mental health professionals who are working in the field of AIDS psychiatry to join our SIG. We especially welcome clinicians in underserved areas to take advantage of the special assistance available in the form of PowerPoint presentations, literature references, and e-mail notifications.

The ongoing form of communication among SIG members is our listserv, but we meet in person each year at the APM annual meeting in November. The next meeting of the APM AIDS Psychiatry SIG — our 8th meeting anniversary — will be at the 2012 APM Annual Meeting in Atlanta, Georgia (November 14–17, 2012). The exact date and time of the AIDS Psychiatry meeting will be announced to listserv members and will be posted on the Web in APM's Annual Meeting section when available.

News Briefs...

New AIDS Psychiatry Section of the WPA. In February 2012, Pedro Ruiz, MD, president of the World Psychiatric Association and founding member of the APM AP SIG, informed us that the executive council of the WPA accepted the proposal that AIDS Psychiatry become a Section of the organization. The proposal was a result of his own dedication and work in HIV psychiatry and the efforts of SIG member Dr. Maria Ferrara, psychiatry resident at the University of Modena & Reggio Emilia in Italy, and Dr. Mary Ann Cohen. We believe that the new AIDS Psychiatry Section will help us to disseminate more information to underserved areas of the world that we have be unable to reach until now.

Upcoming 2012 Annual Meeting. We are delighted to announce that our SIG has submitted three scientific sessions to APM's 2012 meeting — a pre-conference course and two symposia. If accepted, the course would be presented on Wednesday, November 14, and the symposia on Thursday, Friday, or Saturday, November 15–17.

2011 Annual Meeting Award. Founding AIDS Psychiatry SIG member William Breitbart was awarded the Academy's highest honor, the Eleanor and Thomas P. Hackett Memorial Award, for his outstanding work in psycho-oncology as well as in HIV/AIDS and end-of-life care.

2010 Annual Meeting Awards. We are proud that 3 out of the 4 Dorfman Journal Paper Awards were presented at the 2010 Annual Meeting for articles on AIDS psychiatry by our SIG members: Harold Goforth (Best Review Article), Oliver Freudenreich (Honorable Mention, Best Case Review Article), and William Breitbart (Best Original Research Article).

A Brief History of the APM AIDS Psychiatry SIG

Until 2003, there was no organization of psychiatrists and other mental health professionals that was dedicated to the field of AIDS psychiatry. Nevertheless, many mental health clinicians devoted their professional lives to providing care for persons with HIV and AIDS. There was a need for a national and international organization to provide networking and support for, as well as a forum for, the exchange of ideas and collaborative research — an organization to share knowledge, to present work, and to collaborate in education and research.

AIDS psychiatry is a paradigm of psychosomatic medicine, and in November 2004, the Academy of Psychosomatic Medicine agreed to establish a new, special section of AIDS Psychiatry. The APM Executive Council, Executive Director, and administrative staff graciously welcomed us as the Organization of AIDS Psychiatry and provided us with a forum to meet and present our work at the APM annual meetings.

In November 2005, the SIG met for the first time and presented a symposium on AIDS psychiatry at the APM annual meeting in New Mexico. We've met at the APM annual meeting again each year since then and presented a symposium at the meeting every year except 2006.

In May 2008, we met and presented a symposium at the APA annual meeting in collaboration with the APA Office of HIV Psychiatry. That same month we also presented a symposium at the annual meeting of the American Academy of Psychoanalysis and Dynamic Psychiatry. That same year, thanks to administrative support and resources from the Academy, the SIG had a Web page (this page!) and a listserv and began to collaborate to develop a consensus base of current AIDS psychiatry practice.

Thanks to the Academy, the organization has grown from its first gathering of 32 members in 2005 to more than 300 U.S. and international members in 2012. Our name change in the fall of 2009 to the APM AIDS Psychiatry SIG recognizes the important role of the Academy in the growth and development of our SIG as well as our potential role in the APM. We encourage all of our members to join the APM.

Goals of the SIG

The overall goals of the APM AIDS Psychiatry SIG are to:

• Develop a network of mental health professionals working in the area of AIDS psychiatry:
  • For brief informal consultations by e-mail from members
  • To exchange ideas about drug-drug interactions, especially HIV medications and psychotropic medications, and the best medications to use for depression, anxiety, and insomnia—as we experience them in practice, until evidence-based research is available
  • To develop novel ideas for outreach, screening, and treatment
  • To develop an understanding of best practices in AIDS psychiatry
• Promote awareness of AIDS as a public health problem with psychiatric sequelae and associated psychiatric disorders
• Develop and promote programs to educate general psychiatrists and other mental health professionals in HIV/AIDS psychiatric complications and treatment
• Assist psychiatrists in various clinical settings to develop support for prevention of HIV transmission in their patient populations. There is a need to educate general psychiatrists in inpatient and outpatient psychiatry settings about prevention of HIV transmission in persons with both severe mental illness alone and severe mental illness and addictive disorders.
• Help develop and implement strategies to reduce stigma associated with being a person with HIV and AIDS
• Develop and promote education and collaborative research on effective clinical and professional practices in AIDS Psychiatry

Goals and activities for 2012

In addition to continuing to survey SIG members about HIV treatment practices, two task forces are at work for 2012 activities. The first task force, to propose scientific sessions at APM's 2012 Annual Meeting, will:

• Propose and develop an AIDS Psychiatry pre-conference course and two symposia for the APM 2012 Annual Meeting.
  
  The course, which has been submitted for consideration, will be a half-day program designed to provide participants with an overview and update of basic principles of AIDS psychiatry, including all aspects from diagnosis and treatment to prevention and epidemiology.

A research task force, appointed at the 2010 SIG meeting, is led by Kelly Cozza with members Andrew Angelino, Sharon Batista, Philip Bialer, Mary Ann Cohen, Oliver Freudenreich, Harold Goforth, John Grimaldi, Suad Kapetanovic, Chris Kogut, and Karen Johnson. This task force will:

• Develop a study of the psychiatric side effects of antiretroviral medications using efavirenz as a paradigm.
  
  The idea for this study is a result of a dialogue started in the AIDS Psychiatry listserv in November 2010 (see the discussion thread here). The goal of the study is to create a template to survey all APM members and to inform further research on a national level in collaboration with SIG member Marshall Forstein and the APA Office of HIV Psychiatry.

As funds in the Foundation of the Academy of Psychosomatic Medicine grow, we anticipate scholarships and travel awards will become available for trainees and others. Since summer 2010, Dr. Mary Ann Cohen has donated two honoraria totaling $4000 toward this end, and we encourage others to contribute to the Foundation for this purpose.

Membership in the SIG and How to Join

To join the APM AIDS Psychiatry SIG, please send an e-mail indicating your field of interest, your full name and organization, and your telephone number to the chair of the AIDS Psychiatry SIG, Mary Ann Cohen, MD, FAPM, at macohen at nyc dot rr dot com.

We encourage all of our SIG members to also become a member of the Academy of Psychosomatic Medicine. For an AIDS psychiatrist or other mental health clinician, the Academy is an important resource since AIDS psychiatry is characterized by multimorbid severe and complex medical illnesses. The APM is a remarkable organization that meets once a year and no matter how beautiful the location, the meetings are so packed with outstanding faculty and inspiring courses, symposia, and workshops that the location pales by comparison and the meetings are too good to miss! It is an organization that serves as an inspiration, a chance for networking, and a place to learn. Membership has many other advantages including a subscription to the Academy's journal, Psychosomatics. To join the APM, please see How to Join APM.

Special Assistance and Shared Slide Presentations

Several members of our organization have agreed to make their PowerPoint presentations available on a variety of subjects for members and non-members who are new to the field of AIDS psychiatry and would like to develop presentations for the education of clinicians in academic or other settings. We welcome requests from underserved areas where there are no psychiatrists or other mental health professionals and where HIV clinicians need help in providing psychological support to persons with HIV or AIDS and their families. Please send your request to Chair, Mary Ann Cohen, MD, FAPM <macohen at nyc dot rr dot com> and describe the situation about which you would like assistance.

PDFs of the slides from the AIDS Psychiatry symposia at the 2009 and 2010 APM Annual Meetings are available to APM members in the Members' Corner. In addition, the following presentations are available:

A Biopsychosocial Approach to AIDS: The 27th Year
Presented May 8, 2008 by Mary Ann Cohen, MD at the APA Annual Meeting

AIDS Psychiatric Disability Criteria: A Biopsychosocial Approach
Presented September 10, 2008 by Mary Ann Cohen, MD to Social Security Administration

A Biopsychosocial Approach to Pain in Persons with AIDS: Dilemmas in Palliative Care
Presented November 3, 2010 by Mary Ann Cohen, MD to McMaster University

"Trauma, PTSD, and HIV: Psychodynamic and Educational Approaches to Adherence in a Community Medical Setting"
Symposium presented May 7, 2012, in collaboration with the AAPDP, at the APA Annual Meeting by Sharon M. Batista, MD; Mary Ann Cohen, MD; Phil Meyer, LCSW; and Maria Tiamson-Kassab, MD
Part 1 (slides 1-67)     Part 2 (slides 68-131)

Psychodynamics of Trauma, PTSD, and Non-Adherence to Medical Care in Persons with HIV and AIDS
Presented May 7, 2012 by Mary Ann Cohen, MD at the APA Annual Meeting

Update in HIV and AIDS Psychiatry
Presented May 8, 2012 by Mary Ann Cohen, MD at the APA Annual Meeting

HIV through the Life Cycle: Aging of HIV Population
Presented May 8, 2012 by Adriana Carvalhal, MD at the APA Annual Meeting

Psychiatric Disorders
Presented May 8, 2012 by Jordi Blanch, MD at the APA Annual Meeting

If you wish the PowerPoint version of the slides from the presentations above to adapt for your own use, please contact Dr. Mary Ann Cohen at macohen at nyc dot rr dot com.

Other Important AIDS Psychiatry Resources

Special HIV/AIDS Literature Listserv

Robert Malow, PhD, ABPP, director of the AIDS Prevention Program in the Stempel School of Public Health (Florida International University), has been maintaining an HIV/AIDS listserv that has become one of the most critical sources of information to the HIV treatment and research fields.

Since 1997, Dr. Malow has been distributing, through e-mail, current HIV literature usually in the form of abtsracts/summaries to now approximately 5000 researchers nationwide. Abstracts are considered in scope if they examine either behavioral, biological, or psychosocial dimensions of the epidemic, including contextual antecedents, individual risk factors, and prevention intervention design. Items are also included if they further the field in probing macro-level determinants, policy decision making (e.g., cost-effectiveness studies and techniques), and suggest improvements in statistical analysis and methodology. Seminal articles on methods that directly impact the field from epidemiology, neuropsychological and cultural assessment, and biological measurement, are also included. It is an invaluable resource for authors and researchers in the field.

To subscribe to this listserv, send your request to join in an e-mail to Dr. Malow at RMalow at bellsouth dot net and include your name and e-mail address. There is no fee to join the listserv.

New York State HIV Mental Health Guidelines

The New York State Department of Health AIDS Institute, in collaboration with Johns Hopkins University, has been developing guidelines for HIV medical and mental health care for many years. These guidelines have been updated, and we have been asked to make them available to our members. The guidelines are available online at www.hivguidelines.org — use the drop-down menu under "Clinical Guidelines". The guidelines include those relevant to AIDS psychiatry.

American Psychiatric Association HIV Website

The American Psychiatric Association's HIV website at www.psych.org/aids provides information and links to APA-sponsored education programs, training curricula, clinical resources, policy information, and patient education materials for psychiatrists and other medical and mental health professionals.

HIV/AIDS National Strategic Plan Information Resource for South Africa (NSPiSA)

We have received an invitation for you to submit information about your current HIV and AIDS research projects and publications to a database being developed by NSPiSA. Dr. Mary Ann Cohen will be submitting some of the research we have done as a group, and we encourage you to do so as well.

The aim of the NSPiSA database is to allow policy makers, stakeholders and other researchers to stay abreast of current and ongoing research and thus facilitate dialogue between the research community and the South African National Aids Council (SANAC) and its constituent committees and task teams. Please see www.nspisa.com for complete details.

Recent Publications by AIDS Psychiatry SIG Members

Members of the AIDS Psychiatry SIG have published thousands of articles, chapters, and books prior to joining our group. Since joining, many have published hundreds more, including three textbooks of AIDS psychiatry, all of which are available through the publisher (linked below for each book), Amazon, and Barnes and Noble:

Articles

Freudenreich O, Basgoz N, Fernandez-Robles C, Larvie M, Misdraji J:  Case 5-2012— A 39-Year-Old Man with a Recent Diagnosis of HIV Infection and Acute Psychosis.  N Engl J Med 2012; 366(7):648-657.

Samuels E, Khalife S, Alfonso CA, Alvarez R, Cohen MA:  Early childhood trauma, posttraumatic stress disorder, and non-adherence in persons with AIDS: a psychodynamic perspective.  J Am Acad Psychoanal Dyn Psychiatry 2011; 39(4):633-650.
 
AP SIG member Erin Samuels was a psychiatry resident at NYU when she and her co-authors published this article.

Freudenreich O, Goforth HW, Cozza KL, Mimiaga MJ, Safren SA, Bachmann G, Cohen MA:  Psychiatric treatment of persons with HIV/AIDS: an HIV-psychiatry consensus survey of current practices.  Psychosomatics 2010; 51(6):480-488. 

The AP SIG special section, Results of the 2008 HIV Psychiatry Treatment Consensus Survey, is the precursor to publication of this article. The article was a result of the first collaborative research effort by our SIG.

Books

Handbook of AIDS Psychiatry
Mary Ann Cohen, Harold Goforth, Joseph Lux, Sharon Batista, Sami Khalife, Kelly Cozza and Jocelyn Soffer
Oxford University Press, New York, 2010

All the authors are members of both the APM and the AIDS Psychiatry SIG. On February 16, 2011, SIG member Michael Blumenfield, MD posted his review of the book and his online interview of the lead author on www.PsychiatryTalk.com.

The Handbook of AIDS Psychiatry is the companion to the Comprehensive Textbook of AIDS Psychiatry published in 2008 (next item).

Comprehensive Textbook of AIDS Psychiatry
Edited by Mary Ann Cohen and Jack M. Gorman
Oxford University Press, New York, 2008

The editors are members of the SIG, and Cohen and 30 contributors are members of both the SIG and the APM. This book was favorably reviewed by Reuters (2008), three stars by Doody’s Book Review Service (February 2008), New England Journal of Medicine (March 27, 2008), Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry (June 2008), Journal of the American Medical Association (August 6, 2008), and the American Journal of Psychiatry (November 2008).

Psychiatric Aspects of HIV/AIDS
Edited by Francisco Fernandez and Pedro Ruiz
Lippincott Williams & Wilkins, Philadelphia, PA, 2006

The editors and many contributors are members of the SIG.

Previous AIDS Psychiatry SIG Presentations

APA ANNUAL MEETING — MAY 2012
Philadelphia, Pennsylvania

May 7, 2012

"Trauma, PTSD, and HIV: Psychodynamic and Educational Approaches to Adherence in a Community Medical Setting" — APA/AAPDP Collaborative Symposium  [Abstract]

Chair & Discussant: Cesar A. Alfonso, MD

Presentations:

The slides of the four presenters of this symposium are contained in two PDF files:
Part 1 (slides 1-67) and Part 2 (slides 68-131).

• Development of a Trauma and PTSD Curriculum to Meet the Needs of HIV Clinicians and their Patients — Sharon M. Batista, MD
• Psychodynamics of Trauma, PTSD, and Non-Adherence to Medical Care in Persons with HIV and AIDS — Mary Ann Cohen, MD
• Our Patients With Trauma Are Nonadherent to Medical Care: An Innovative Approach to Education in an AIDS Clinic — Maria Tiamson-Kassab, MD
• Results and Outcomes of a Trauma, PTSD, and HIV Training Program — Phil Meyer, LCSW

May 8, 2012

"Update in HIV and AIDS Psychiatry"

Chair & Discussant: Mary Ann Cohen, MD

Presentations:

• Update in HIV and AIDS Psychiatry — Mary Ann Cohen, MD
• HIV Through the Life Cycle: Childhood, Adolescence, and Reproductive Health — Suad Kapetanovic, MD
• HIV through the Life Cycle: Aging of HIV Population — Adriana Carvalhal, MD
• Psychiatric Disorders — Jordi Blanch, MD
• Multimorbid Medical Illness: Non-HIV and HIV-related — Joseph Lux, MD and Kelly Cozza, MD
• Prevention and Future Directions — Maria Tiamson-Kassab, MD

November 16, 2011
APM Annual Meeting
Phoenix, Arizona

Pre-conference Course:
"AIDS Psychiatry Update for the C-L Psychiatrist"
Please see the course description in the 2011 Annual Meeting section of the APM website.

November 18, 2011
APM Annual Meeting
Phoenix, Arizona

"Innovative Approaches to Clinical Care, Research, and Prevention in AIDS Psychiatry"  [Abstract]

Chair: Mary Ann Cohen, MD, Mount Sinai School of Medicine
Discussant: John Grimaldi, MD, Harvard Medical School

Presentations:

• Clinical Experiences in Caring for Persons with AIDS on Efavirenz — Jordi Blanch, MD, PhD, Hospital Clinic De Barcelona
• Update on Neuropsychiatric Side Effects of Efavirenz: Report from the AP SIG Research Task Force — Kelly L. Cozza, MD, Uniformed Services University; Andrew Angelino, MD, Johns Hopkins University Medical School
• HIV-Associated CNS Vulnerability in the Antiretroviral Era — Suad Kapetanovic, MD, National Institute of Mental Health
• The Inclusion of SMI on the HIV Indicator Disease List of the HIV in Europe Group — Maria Ferrara, MD and Silvia Ferrari, MD, University of Modena & Reggio Emilia
• Supervised Injection Sites and Other Preventive Measures in AIDS Psychiatry —
  Adriana Carvalhal, MD, McMaster University School of Medicine

November 12, 2010
APM Annual Meeting
Marco Island, Florida

"Educating Clinicians about HIV-Associated Dementia "

Chair: Mary Ann Cohen, MD
Discussant: Philip A. Bialer, MD

Presentations (PDFs of slides are available in the Members' Corner):

• Risk Factors for HIV-Associated Neurocognitive Disorders (HAND) — Jordi Blanch, MD, PhD
• Early Recognition of HIV-Associated Dementia: Differential Diagnosis — Adriana Carvalhal, MD, MSc, PhD
• Early Recognition of HAND: Complexities of Assessment & Screening — Stephen J. Ferrando, MD, FAPM
• Developing Screening Tools for HAND and Assessing Current Practices — Andrew Angelino, MD and John Grimaldi, MD

November 13, 2009
APM Annual Meeting
Las Vegas, Nevada

"Quality of Care in AIDS Psychiatry"

Chair: Mary Ann Cohen, MD
Discussant: Philip A. Bialer, MD

Presentations (PDFs of slides are available in the Members' Corner):

• Safe and Cost-Effective Care in HIV Psychiatry—Karen M. Johnson, MD
• Organization of AIDS Psychiatry (OAP) Consensus Survey of HIV Psychiatric Treatments —Oliver Freudenreich, MD
• Salvaging Quality of Care during the Transitions from Childhood to Adulthood in HIV Psychiatry—Lori Wiener, PhD and Maryland Pao, MD
• Preventing Bad Outcomes in HIV Psychiatry—Mary Ann Cohen, MD

November 20, 2008
APM Annual Meeting
Miami, FL

"AIDS Psychiatry Across the Life Cycle"

Moderator: Mary Ann Cohen, MD
Discussant: Jon A. Levenson, MD

Presentations:

• Transitioning from Childhood to Adulthood in HIV Care—Lori Wiener, PhD
• Long-Term Non-Progressors with HIV—Philip Bialer, MD
• Co-infection with HIV and HCV—Aly Rifai, MD
• Geriatric AIDS Psychiatry: A Hidden Epidemic—Mary Ann Cohen, MD

May 8, 2008
APA Annual Meeting
Washington, DC

"AIDS Psychiatry in 2008"
This symposium launched a presentation collaboration between the APA Office of HIV Psychiatry and the Organization of AIDS Psychiatry.

Chairs: Mary Ann Cohen, MD and Marshall Forstein, MD

Presentations:

• A Biopsychosocial Approach to AIDS: The 27th Year—Mary Ann Cohen, MD
• HIV-Associated Sleep Disorders: A Comprehensive Approach—Harold Goforth, MD
• HIV-Associated Neurocognitive Disorders: An Update—Stephen Ferrando, MD
• Update on HIV Treatment in Severely Mentally Ill—Francine Cournos, MD
• Psychotherapeutic Aspects of Lipodystrophy in Persons with AIDS—
  Marshall Forstein, MD
• Methamphetamine and HIV Treatment—Antoine Douaihy, MD

May 3, 2008
American Academy of Psychoanalysis and Dynamic Psychiatry Annual Meeting
Washington, DC

"A Biopsychosocial Approach to AIDS Psychiatry: An Update"

Chair: Mary Ann Cohen, MD
Discussant: Cesar A. Alfonso, MD

Presenters:

• A Biopsychosocial Approach to AIDS—Mary Ann Cohen, MD
• Psychodynamics of HIV Stigma—Sami Khalife, MD
• Creating a Facilitating Environment for Family-Centered Advance Care Planning for Teens with HIV/AIDS—Maureen Lyon, PhD
• Psychodynamics of Sexual Risk-Taking in Gay Men—Jeffrey Akman, MD
• A Medical Update on AIDS—Joseph Lux, MD

November 17, 2007
APM Annual Meeting
Amelia Island, FL

"AIDS Psychiatry: Past, Present, and Future"

Moderator & Discussant: Mary Ann Cohen, MD

Presentations:

• The History of AIDS Psychiatry: A Biopsychosocial Approach—Mary Ann Cohen, MD
• AIDS Stigma—Sami Khalife, MD
• A Medical Update on AIDS—Joe Z. Lux, MD
• Primary Areas for Current and Future Research in AIDS Psychiatry—Stephen J. Ferrando, MD and Maryland Pao, MD

November 18, 2005
APM Annual Meeting
Santa Ana Pueblo, NM

"AIDS: Survival and Adherence — A Paradigm for Psychosomatic Medicine"

Chairperson: Mary Ann Cohen, MD
Co-Chairperson: Rosalind G. Hoffman, MD
Discussant: Jeffrey J. Weiss, PhD

Presentations:

• Adherence to Care in Persons with HIV and AIDS—David Bangsberg, MD, MPH
• Survival and Adherence in Persons with AIDS and Mental Illness—Glenn Treisman, MD, PhD
• AIDS as a Paradigm for Psychosomatic Medicine and
  Introduction to the Organization of AIDS Psychiatry—Mary Ann Cohen, MD, FAPM