Am J Psychiatry 1996; 153:1487-1488
Copyright © 1996 by American Psychiatric Association
Unreliability of current screening tests for syphilis in chronic psychiatric patients
RR Reeves, HB Pinkofsky and KK Kennedy
Department 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.
