el-Mallakh R S
Office on AIDS, Prince George's County Health Department, Cheverly, Maryland.
AIDS Care. 1992;4(4):381-7. doi: 10.1080/09540129208253109.
Human immunodeficiency virus (HIV) frequently enters the central nervous system (CNS) soon after infection, and frequently produces a wide variety of neurologic, cognitive, and psychiatric complications. Although, the entire spectrum of psychiatric illnesses may be seen in individuals with HIV infection, most are probably not directly caused by the virus. Psychiatric manifestations that are the direct result of HIV infection are usually seen in the setting of HIV-associated dementia. In this paper, it is proposed that these psychiatric manifestations of HIV infection can be phenomenologically separated into positive and negative symptoms. Negative symptoms are deficit states presenting as cognitive, social, or motivational deterioration; positive symptoms are psychotic or manic states that may occur in the course of the dementing illness. It is further purposed that there is a window of vulnerability to psychosis or mania that occurs relatively early in the dementing process. Consequently, advancing dementia would be expected to be associated with remission of psychosis.
人类免疫缺陷病毒（HIV）在感染后不久常常进入中枢神经系统（CNS），并经常引发各种各样的神经、认知和精神并发症。虽然，HIV感染者可能会出现整个精神疾病谱，但大多数可能并非直接由病毒引起。HIV感染直接导致的精神表现通常出现在HIV相关痴呆的背景下。本文提出，HIV感染的这些精神表现从现象学上可分为阳性症状和阴性症状。阴性症状是表现为认知、社交或动机衰退的缺陷状态；阳性症状是可能在痴呆病程中出现的精神病性或躁狂状态。进一步推测，在痴呆过程中相对较早的时候会出现一个对精神病或躁狂的易损期。因此，预计痴呆进展会与精神病症状的缓解相关。
