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Unreliability of current screening tests for syphilis in chronic psychiatric patients
R R Reeves1, H B Pinkofsky, K K Kennedy
1Department of Psychiatry, Louisiana State University School of Medicine in Shreveport 71130-3932, USA.
Objective:
This study examined whether psychiatrists perform adequate diagnostic screening for syphilis in patients with chronic mental illness.
Method:
Two hundred patients with chronic mental illness underwent testing for syphilis with the commonly used RPR test and the microhemagglutination assay for Treponema pallidum (MHA-TP). Sensitivities of the two tests were compared.
Results:
A substantial number of patients with negative results on RPR tests had reactive MHA-TPs and would have not been identified as having had syphilis with the use of RPR testing alone.
Conclusions:
Nontreponemal tests such as the RPR test are less likely than treponemal tests to detect syphilis appropriately in chronically mentally ill patients, and specific treponemal tests such as the MHA-TP should be considered.