Requests for psychiatric consultation concerning 22 patients with AIDS and ARC

Psychiatric consultation was requested for 22 of 150 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) admitted to St Vincent's Hospital, Sydney. The mean age of the patients was 35 years and all were homosexual or bisexual men. Ten patients had an organic brain syndrome: six as a result of cerebral opportunistic infection, two due to metabolic or iatrogenic causes and two apparently due to the direct neurotropic effects of the human immunodeficiency virus (HIV). Hallucinations and delusions were documented in five patients, of whom two had symptoms that fulfilled the criteria for a diagnosis of functional psychosis. Four patients were diagnosed as having adjustment disorder-depressive mood and one patient may have had a major depressive illness. Marked denial of illness was seen in two patients and four had markedly slow mentation with only mild or no evidence of cognitive impairment. It is concluded that patients with AIDS may have a wide variety of neuropsychiatric manifestations.