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AIDS mania

C G Lyketsos1, J Schwartz, M Fishman

  • 1AIDS Psychiatry Service and Neuropsychiatry and Memory Group, Johns Hopkins University, Baltimore, Maryland 21287, USA.

The Journal of Neuropsychiatry and Clinical Neurosciences
|April 1, 1997
PubMed
Summary
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HIV-associated mania presents differently based on onset timing relative to CD4 count. Late-onset mania in HIV patients is linked to cognitive issues, unlike early-onset mania.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Psychiatry

Background:

  • Human Immunodeficiency Virus (HIV) infection can impact neurological and psychiatric health.
  • Mania is a recognized neuropsychiatric complication in individuals with HIV.
  • The timing of manic episodes relative to immune status (CD4 count) may influence presentation.

Purpose of the Study:

  • To investigate differences in clinical presentation and history between early-onset and late-onset mania in patients with HIV.
  • To explore potential distinctions in pathophysiology based on the timing of manic episodes in relation to CD4 T-cell counts.

Main Methods:

  • Twenty patients diagnosed with HIV infection and mania were retrospectively analyzed.
  • Patients were categorized into two groups based on CD4 count at the time of their first manic episode: < 200 cells/mm³ (late onset) or ≥ 200 cells/mm³ (early onset).

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  • Sociodemographic data, personal/family psychiatric history, and manic symptom profiles were compared between the two groups.

    • Main Results:

    • Late-onset mania patients (CD4 < 200) were less likely to report personal or family histories of mood disorders compared to early-onset patients.
    • Late-onset mania was associated with a higher prevalence of dementia and cognitive slowing.
    • Distinct manic symptom profiles were observed between the early-onset and late-onset groups.

    Conclusions:

    • The timing of manic episodes in HIV-infected individuals, relative to immune suppression, is associated with significant differences in clinical presentation.
    • Late-onset mania in HIV may be linked to underlying neurocognitive deficits or different pathophysiological mechanisms.
    • Further research is warranted to elucidate the distinct pathophysiological pathways contributing to early- versus late-onset mania in HIV.