Abstract
OBJECTIVE: To assess the relationship between HIV-associated psychotic symptoms (i.e., delusions, hallucinations) and demographic, psychopathological and medical variables by comparing patients with and without cerebral opportunistic infections or metabolic encephalopathy. DESIGN: Cross-sectional study. PATIENTS: 26 patients admitted to hospital with HIV and new-onset psychotic symptoms, defined according to DSM-III-R criteria. OUTCOME MEASURES: A semistructured psychiatric interview using the Psychopathology Assessment Scale (AMDP-4) of the Association for Methodology and Documentation in Psychiatry system. Comprehensive medical assessments, including laboratory tests and computed tomographic scans, were also performed. RESULTS: Patients with cerebral opportunistic infections or metabolic encephalopathy (i.e., "secondary" psychosis, n = 13) were more likely to show disorders of consciousness, disorders of orientation and disturbances of attention and memory than those with no evidence of HIV-related cerebral disease (i.e., "primary" psychosis, n = 13); 10 patients (77%) with cerebral opportunistic infections or metabolic encephalopathy and only 1 (8%) patient without (p < 0.001) were diagnosed with delirium. These associations were stronger for the "secondary" patients with no focal brain lesions than for those with lesions. CONCLUSIONS: These findings suggest that "organic" symptoms of psychosis in those infected with HIV are related to the systemic and cerebral complications of HIV infection rather than to the psychotic process itself.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ban T. A., Guy W., Wilson W. H. The AMDP-system in chronic hospitalized schizophrenics. Compr Psychiatry. 1985 Jul-Aug;26(4):370–374. doi: 10.1016/0010-440x(85)90093-8. [DOI] [PubMed] [Google Scholar]
- Buhrich N., Cooper D. A., Freed E. HIV infection associated with symptoms indistinguishable from functional psychosis. Br J Psychiatry. 1988 May;152:649–653. doi: 10.1192/bjp.152.5.649. [DOI] [PubMed] [Google Scholar]
- Halstead S., Riccio M., Harlow P., Oretti R., Thompson C. Psychosis associated with HIV infection. Br J Psychiatry. 1988 Nov;153:618–623. doi: 10.1192/bjp.153.5.618. [DOI] [PubMed] [Google Scholar]
- Harris M. J., Jeste D. V., Gleghorn A., Sewell D. D. New-onset psychosis in HIV-infected patients. J Clin Psychiatry. 1991 Sep;52(9):369–376. [PubMed] [Google Scholar]
- Maxwell S., Scheftner W. A., Kessler H. A., Busch K. Manic syndrome associated with zidovudine treatment. JAMA. 1988 Jun 17;259(23):3406–3407. [PubMed] [Google Scholar]
- Sewell D. D., Jeste D. V., Atkinson J. H., Heaton R. K., Hesselink J. R., Wiley C., Thal L., Chandler J. L., Grant I. HIV-associated psychosis: a study of 20 cases. San Diego HIV Neurobehavioral Research Center Group. Am J Psychiatry. 1994 Feb;151(2):237–242. doi: 10.1176/ajp.151.2.237. [DOI] [PubMed] [Google Scholar]
- Shenton M. E., Kikinis R., Jolesz F. A., Pollak S. D., LeMay M., Wible C. G., Hokama H., Martin J., Metcalf D., Coleman M. Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study. N Engl J Med. 1992 Aug 27;327(9):604–612. doi: 10.1056/NEJM199208273270905. [DOI] [PubMed] [Google Scholar]