PsychEd: Educational Psychiatry Podcast

PsychEd Episode 57: HIV psychiatry with Dr. Adriana Carvalhal and Dr Leigh Van Den Heuvel

PsychEd: Educational Psychiatry Podcast

Show Notes

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers HIV/AIDS psychiatry with special guests from two international settings to provide complementary perspectives on HIV psychiatry. Dr. Adriana Carvalhal, HIV Psychiatrist and Staff Psychiatrist at Scarborough Health Network in Canada and Dr. Leigh Van Den Heuvel, Psychiatrist and Associate Professor in the Department of Psychiatry, at Stellenbosch University in South Africa. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Understand the unique mental health needs of people living with HIV and the bidirectional relationship between HIV and mental health

Identify HIV-specific mental health disorders and how to screen for these conditions

Outline the overall approach to treatment for HIV patients with mental health disorders

Guests: Dr. Adriana Carvalhal and Dr Leigh Van Den Heuvel Produced by: Saja Jaberi (MD), Kate Braithwaite (MD) and Gaurav Sharma (PGY5) Hosts: Kate Braithwaite (MD) and Gaurav Sharma (PGY5) Audio editing by: Gaurav Sharma (PGY5) Show notes by: Saja Jaberi (MD) and Gaurav Sharma (PGY5) Conflicts of Interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Generic names are used for all medications referenced. Contents: Introduction - 0:19

Learning objectives - 3:52

The bidirectional relationship between HIV and psychiatric illness - 4:24

Prevalence of psychiatric illness in HIV - 9:56

Screening for psychiatric illness in HIV populations - 12:11

HIV Associated Neurocognitive Disorder (HAND) - 19:27

Diagnostic Criteria - 20:19

Clinical Presentation & Etiology - 23:03

Risk Factors - 26:56

Screening Tools - 32:06

Treatment - 36:59

HIV Psychiatry case example - 39:48

Navigating the differential diagnosis - 41:44

Initial management & addressing comorbidities - 44:30

Drug-drug interactions between antiretroviral and psychiatric medications - 48:04

Review of learning objectives & final thoughts - 52:04

Outro - 55:55

Resources: Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Canada (occguidelines.com)

Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2020 - Canada.ca

HIV and Clinical Depression

https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-Anxiety-2012.pdf

https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-CognitiveDisorder-2012.pdf

International HIV Dementia Scale (IHDS) - Mental Health Screening - National HIV Curriculum (uw.edu)/

Liverpool HIV Interactions (hiv-druginteractions.org)

References: Angelovich TA, Churchill MJ, Wright EJ, Brew BJ. New Potential Axes of HIV Neuropathogenesis with Relevance to Biomarkers and Treatment. Curr Top Behav Neurosci. 2021;50:3-39. doi: 10.1007/7854_2019_126. PMID: 32040843.

Angelovich TA, Churchill MJ, Wright EJ, Brew BJ. New Potential Axes of HIV Neuropathogenesis with Relevance to Biomarkers and Treatment. Curr Top Behav Neurosci. 2021;50:3-39. doi: 10.1007/7854_2019_126. PMID: 32040843.

Awori V, Mativo P, Yonga G, Shah R. The association between asymptomatic and mild neurocognitive impairment and adherence to antiretroviral therapy among people living with human immunodeficiency virus. South Afr J HIV Med. 2018 Apr 12;19(1):674. doi: 10.4102/sajhivmed.v19i1.674. PMID: 29707383; PMCID: PMC5913780.

Bloch M, Kamminga J, Jayewardene A, Bailey M, Carberry A, Vincent T, Quan D, Maruff P, Brew B, Cysique LA. A Screening Strategy for HIV-Associated Neurocognitive Disorders That Accurately Identifies Patients Requiring Neurological Review. Clin Infect Dis. 2016 Sep 1;63(5):687-693. doi: 10.1093/cid/ciw399. Epub 2016 Jun 19. PMID: 27325690; PMCID: PMC4981762.

Clinical Care Guidelines for Adults and Adole

More from PsychEd: Educational Psychiatry Podcast

Oct 1, 2026

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers medical considerations in eating disorders. Hosts: Dr. Shelly Palchick (PGY1) and Dr. Angad Singh (PGY3) Audio Editing: Dr. Angad Singh (PGY3) For more PsychEd, follow us on Instagram (⁠⁠⁠⁠⁠⁠⁠⁠@psyched.podcast⁠⁠⁠⁠⁠⁠⁠⁠), Facebook (⁠⁠⁠⁠⁠⁠⁠⁠PsychEd Podcast⁠⁠⁠⁠⁠⁠⁠⁠), X (⁠⁠⁠⁠⁠⁠⁠⁠@psychedpodcast⁠⁠⁠⁠⁠⁠⁠⁠), and Bluesky (⁠⁠⁠⁠⁠⁠⁠⁠@psychedpodcast.bsky.social‬⁠⁠⁠⁠⁠⁠⁠⁠). You can email us at ⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠ and visit our website at⁠⁠⁠⁠⁠⁠⁠⁠ psychedpodcast.org⁠⁠⁠⁠⁠⁠.⁠

Sep 1, 2026

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers homelessness and mental illness with Dr. Vicky Stergiopoulos, senior scientist with the General Adult Psychiatry and Health Systems Division at the Centre for Addiction and Mental Health (CAMH). She is also a full professor in the Department of Psychiatry and the Institute of Health Policy, Management and Evaluation at the University of Toronto. She has served in several administrative roles, including vice-chair, clinical and innovation (2017-2022) and co-Director of the Division of Adult Psychiatry and Health Systems (2012-2017) in the Department of Psychiatry, as well as physician-in-chief at the Centre for Addiction and Mental Health (2016-2022), psychiatrist-in-chief at St. Michael’s Hospital (2011-2016) and medical director, Inner City Health Associates (2017-2011). Dr. Stergiopoulos completed her medical training at Dalhousie University and residency training in psychiatry at the University of Toronto. She holds a MHSc in health administration from the University of Toronto’s Institute for Health Policy, Management and Evaluation and completed director’s education training at the Rotman School of Management. The learning objectives for this episode are as follows: Define homelessness and housing insecurity and identify key social determinants that shape health outcomes in this population

Sep 1, 2026

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of CYP450 metabolism as it applies to psychotropic medication. Hosts: Dr. Celine Prell (PGY4), Dr. Angad Singh, (PGY3) Audio Editing: Dr. Celine Prell (PGY4), Dr. Angad Singh, (PGY3) For more PsychEd, follow us on Instagram (⁠⁠⁠⁠⁠⁠⁠@psyched.podcast⁠⁠⁠⁠⁠⁠⁠), Facebook (⁠⁠⁠⁠⁠⁠⁠PsychEd Podcast⁠⁠⁠⁠⁠⁠⁠), X (⁠⁠⁠⁠⁠⁠⁠@psychedpodcast⁠⁠⁠⁠⁠⁠⁠), and Bluesky (⁠⁠⁠⁠⁠⁠⁠@psychedpodcast.bsky.social‬⁠⁠⁠⁠⁠⁠⁠). You can email us at ⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠ and visit our website at⁠⁠⁠⁠⁠⁠⁠ psychedpodcast.org⁠⁠⁠⁠⁠⁠.⁠

Jul 31, 2026

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Acceptance and Commitment Therapy (ACT) with Dr. Kenneth Fung and Dr. Iline Guan. Dr. Kenneth Fung is Staff Psychiatrist at the Toronto Western Hospital, University Health Network. He is Professor and Director of Global Mental Health with the Department of Psychiatry at the University of Toronto. His research, teaching, and clinical interests include both cultural psychiatry and psychotherapy, especially ACT, Cognitive Behavioural Therapy (CBT), and mindfulness. He is the Block Co-coordinator of the Cultural Psychiatry Core Seminars for psychiatry residents, and the seminar co-lead and psychotherapy supervisor in CBT at the University Health Network. Dr. Guan is a psychiatrist who practices outpatient general psychiatry at the Centre for Addiction and Mental Health in Toronto, where she works in the Mood and Anxiety Ambulatory Services and the Northern Psychiatric Outreach Program. She also works with Inner City Health Associates in downtown Toronto. She has had training across various psychotherapy modalities, including psychodynamic therapy, CBT, DBT, IPT, MBSR/MBCT, and ACT. She is involved in resident teaching and psychotherapy supervision at the University of Toronto, and has implemented a pilot ACT group program in the Mood and Anxiety clinic at CAMH. The learning objectives for this episode are as follows: Describe the theoretical model and core processes underlying ACT

Jul 31, 2026

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers factitious disorder. Hosts: Jo Kikukawa (MS3), Dr. Kate Braithwaite Audio editing: Dr. Kate Braithwaite References: 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, text revision (DSM-5-TR). 5th ed. Washington, D.C.: American Psychiatric Association Publishing; 2022. 2. Irwin, M. R., Bursch, B., & Solomon, D. (2025, July 21). Factitious disorder imposed on self (Munchausen syndrome). UpToDate. https://www.uptodate.com/contents/factitious-disorder-imposed-on-self-munchausen-syndrome?search=factitious+disorder&source=search_result&selectedTitle=1~90&usage_type=default&display_rank=1&searchCorrelationId=681d447e-f8e6-4338-b905-ff937cad5972&searchCorrelationTerm=factitious+disorder#H368608737 3. PsychDB. (2021, December). Factitious Disorder. Factitious Disorder - PsychDB 4. Roesler, T. A., & Jenny, C. (2026, June 12). Medical child abuse (Munchausen syndrome by proxy). UpToDate. https://www.uptodate.com/contents/medical-child-abuse-munchausen-syndrome-by-proxy?search=factitious+disorder&source=search_result&selectedTitle=3~90&usage_type=default&display_rank=3&searchCorrelationId=681d447e-f8e6-4338-b905-ff937cad5972&searchCorrelationTerm=factitious+disorder#H90255160 5. Yates, G., & Bass, C. (2017). The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases. Child abuse & neglect, 72, 45–53. https://doi.org/10.1016/j.chiabu.2017.07.008 For more PsychEd, follow us on Instagram (⁠⁠⁠⁠⁠⁠@psyched.podcast⁠⁠⁠⁠⁠⁠), Facebook (⁠⁠⁠⁠⁠⁠PsychEd Podcast⁠⁠⁠⁠⁠⁠), X (⁠⁠⁠⁠⁠⁠@psychedpodcast⁠⁠⁠⁠⁠⁠), and Bluesky (⁠⁠⁠⁠⁠⁠@psychedpodcast.bsky.social‬⁠⁠⁠⁠⁠⁠). You can email us at ⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠ and visit our website at⁠⁠⁠⁠⁠⁠ psychedpodcast.org⁠⁠⁠⁠⁠⁠.

See all episodes →