HIV-ASSOCIATED PSYCHOSIS - A STUDY OF 20 CASES

Objective: Psychosis is an uncommon but serious complication of infect ion with HIV. This article presents the results of a study of HIV-infe cted individuals with psychosis. Method: The authors evaluated 20 HIV- infected melt who had noniatrogenic new-onset psychosis without deliri um, current substance abuse, or previous psychotic episodes. Clinical, neuropsychological, CSF, magnetic resonance imaging, and neuropatholo gic assessments were made. A comparison group consisting of 20 nonpsyc hotic 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 fro m 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 show ed a trend toward greater global neuropsychological impairment. Conclu sions: New-onset psychosis may be, at least in part, a manifestation o f an HIV-associated encephalopathy.