It is known that HIV can directly infect the CNS and, as a result of such infection, neuropsychological alterations with cognitive, behavioural and motor manifestations can be developed. In this study we seek to determine whether seropositivity is associated with a poor neuropsychological performance in patients with a history of intravenous drug consumption (n=90). For this purpose we carried out an extensive neuropsychological evaluation and compared their performance with that of two seronegative control groups, one comprised of subjects with no history of drug abuse (n=22), which allowed us to obtain a reference of normal neuropsychological performance, and the other of seronegative subjects with a history of drug abuse (n=48), which allowed us to differentiate whether the performance of the seropositive subjects derives from their history of drug abuse. The results reveal that HIV infection in drug users is associated with deficits in attention, verbal and visual memory, verbal skills, concept formation and reasoning, visual-constructive skills, manual dexterity, and perceptive-motor speed, which cannot be attributed to a history of drug abuse. However, the seronegative drug users also showed some of these alterations, which suggests that seropositivity is not only associated with a decrease in performance in these tasks, but also adds to the alterations seen in seronegative subjects as a consequence of drug abuse.

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Depression is one of the most prevalent mental disorders and a notably heterogeneous condition with regard to etiology, symptom expression, course, and treatment response. This is why it is extremely unlikely that a “one size fits all” approach to the treatment of depression will be particularly effective. Quite the contrary, it is clear that the future of the treatment of depression may lie in a combined disorder- and person-centred, tailored-made approach, which takes into account the broader interpersonal context and life history of the individual. Depressed patients with a characteristic cognitive-affective schema of self-critical perfectionism are prone to typical dysfunctional transactional cycles or dominant interpersonal narratives in which rage, distrust and ambivalence are apparent. In addition to this, in these subtype of depressed patients is common to find the overuse of attachment deactivating strategies, in response to threats to attachment relationships specially, and the inhibition of mentalizing as a defensive response to the feelings of rage, emptiness and sadness that are developmentally linked to attachment experiences. The implications of these findings for treatment, particularly with regard to the nature of the therapeutic relationship, are readily important. In this poster we take several cases in order to detail the main psychodynamics and the dominant interpersonal narratives of this subtype of depressed patients and to specify a therapeutic proposal tailored for them.Disclosure of interestThe authors have not supplied their declaration of competing interest.