Am J Psychiatry 1994; 151:237-242
Copyright © 1994 by American Psychiatric Association
HIV-associated psychosis: a study of 20 cases. San Diego HIV Neurobehavioral Research Center Group
DD Sewell, DV Jeste, JH Atkinson, RK Heaton, JR Hesselink, C Wiley, L Thal, JL Chandler and I Grant
Department 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.
