el-Mallakh R S
National Institute of Mental Health, Neuropsychiatric Research Hospital, Washington, D.C.
Int J Psychiatry Med. 1991;21(4):383-91. doi: 10.2190/08UJ-61E8-B2RF-0TCN.
Cases of mania associated with acquired immune deficiency syndrome (AIDS) are reviewed in an attempt to elucidate patterns that may be helpful in guiding treatment, determining prognosis, and understanding pathophysiology. Fourteen well-described cases in the English language literature were critically reviewed. Data was collected regarding chronological appearance of signs and symptoms, specific psychiatric symptoms, associated neurologic and cognitive function, objective testing of brain structure and function, and outcome. When mania or hypomania occur in the setting of a human immunodeficiency virus (HIV) infection, it frequently occurs once and does not recur. AIDS-associated manic states are adequately responsive to available antimanic agents, however, AIDS patients may be more prone to deleterious side effects. Although mania or hypomania may be the presenting complaints that lead to the discovery of human immunodeficiency virus (HIV) seropositive status, mania tends to occur in people exhibiting signs of immunodeficiency as is exemplified, in the sample, by death occurring within six months of the psychiatric presentation in nearly a quarter of the patients. It is hypothesized that AIDS-related mania and agitated psychosis may be related to increased intracellular free calcium.
对与获得性免疫缺陷综合征（艾滋病）相关的躁狂病例进行了综述，以试图阐明可能有助于指导治疗、确定预后和理解病理生理学的模式。对英文文献中十四例描述详尽的病例进行了严格审查。收集了有关症状和体征的时间出现、特定精神症状、相关神经和认知功能、脑结构和功能的客观测试以及结果的数据。当在人类免疫缺陷病毒（HIV）感染的背景下出现躁狂或轻躁狂时，通常只发生一次且不会复发。与艾滋病相关的躁狂状态对现有的抗躁狂药物有充分反应，然而，艾滋病患者可能更容易出现有害的副作用。虽然躁狂或轻躁狂可能是导致发现人类免疫缺陷病毒（HIV）血清阳性状态的主诉，但躁狂往往发生在有免疫缺陷迹象的人群中，如在样本中，近四分之一的患者在精神症状出现后的六个月内死亡就证明了这一点。据推测，与艾滋病相关的躁狂和激越性精神病可能与细胞内游离钙增加有关。
