engleski

HIV – positive young male patient with bipolar disorder and psychoactive substances addiction

School and adolescent medicine is a branch of preventive medicine that keeps track of not only physical status, but also psychological development of children and young people. A young man shown in this case report is an example of challenges faced by school medicine doctors and shows us that we should discuss more about mental health of young people, as well as problems due to drug and alcohol abuse among them. Case report In November 2019, a 22 year-old male patient came to the Department of School Medicine due to systematic check-up. During check-up, young men's physical status was fine, nevertheless, during talk, it has been found out that this young man is living in a non-typical family circumstances, moreover, he has been consuming marijuana since he was 15 years old, as well as ecstasy and amphetamins since he was 18 years old. Patient has been regularly consuming alcohol, often in great amounts. Besides, until now, patient has had around 30 sex-partners (first sexual intercourse was with 16 years), he is homosexually oriented and for the last three years, due to his HIV positivity, he has been taking a medicine which contains three different medications: emtricitabine, rilpivirine and tenofovir alafenamide. In 2017 patient has had his first episode of visual-auditory hallucinations, for which he was hospitalized in Clinical Hospital Centre in Zagreb, when psychiatrist diagnosed him with bipolar disorder and prescribed him psychiatric therapy which he has been taking regularly. Moreover, patient mentioned his grandmother suffered from schizophrenia and his father suffered from PTSD, which led him to commit suicide when patient was 9 years old. After revealing the questionnaire answers about mental health, it is clear that the patient has extremely low self-esteem, along with disrupted image of himself and his values. After the check-up was performed and the patient was advised about improvement of mental health, but also about benefits of quitting doing drugs, smoking and consuming alcohol, patient was given a new check-up date in two weeks. He was also suggested to turn to psychiatrist or to mental health department, since his symptoms were all connected to mental problems and since depressive episode has occurred. Despite of activities being done in the domain of school medicine physician, young men's state had not improved. Therefore, these types of patients demand multidisciplinary health care, where psychiatrist and psychologist need to be included, in order to maximize patient's potentials and to bring his own mental health to the highest possible level.

alcoholism, drugs, HIV positivity, mental health

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