Early-onset versus late-onset HIV-related secondary mania in Uganda

First-episode secondary mania in human immunodeficiency virus (HIV) infection has been described among samples of predominantly Caucasian, HIV-positive male patients in developed countries.

The goal of this study was to compare the demographic and clinical characteristics of HIV-positive patients with early-onset and late-onset first-episode secondary mania in HIV infection. There were previous findings of an association between late-onset mania and severe cognitive impairment.

Subjects were HIV inpatients with clinically-confirmed mania, who received standard demographic, psychiatric, physical, and laboratory assessments. Early-onset patients had CD4 cell counts > 200 mm(3); late-onset patients had CD4 cell counts < or = 200 mm(3).

There were no demographic or cognitive differences between early-onset and late-onset mania patients, and high rates of psychotic symptoms in both groups. However, late-onset patients had more manic symptoms.

Late-onset HIV mania patients had more severe psychopathology and, thus, demonstrated a greater need for highly active retroviral therapy.