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HIV-associated psychosis: a study of 20 cases. San Diego HIV Neurobehavioral Research Center Group
D D Sewell1, D V Jeste, J H Atkinson
1Department of Psychiatry, School of Medicine, University of California, San Diego.
Objective:
Psychosis is an uncommon but serious complication of infection with HIV. This article presents the results of a study of HIV-infected individuals with psychosis.
Method:
The authors evaluated 20 HIV-infected men who had noniatrogenic new-onset psychosis without delirium, current substance abuse, or previous psychotic episodes. Clinical, neuropsychological, CSF, magnetic resonance imaging, and neuropathologic assessments were made. A comparison group consisting of 20 nonpsychotic HIV-infected men matched to the psychotic subjects with respect to age, race, years of education, and Centers for Disease Control HIV stage was also evaluated.
Results:
The psychotic patients differed from the nonpsychotic comparison subjects in having significantly higher rates of past stimulant and sedative/hypnotic abuse or dependence and, at follow-up, a significantly higher rate of mortality. They also showed a trend toward greater global neuropsychological impairment.
Conclusions:
New-onset psychosis may be, at least in part, a manifestation of an HIV-associated encephalopathy.