Perry S W, Tross S
Public Health Rep. 1984 Mar-Apr;99(2):200-5.
A retrospective review of the charts of 52 patients with acquired immune deficiency syndrome (AIDS) in the New York Hospital was conducted to determine the prevalence of recorded psychiatric complications and the use of psychiatric consultation. Neuropsychiatric complications were found to be pervasive clinical features in AIDS patients hospitalized during acute illness. Mood disturbance was identified in an overwhelming majority of the patients (82.7 percent), and signs of organic mental syndrome (DSM III) were noted in 65.4 percent; references to neuropsychiatric complications appeared in every patient's chart. Neurological complications were seldom explicitly diagnosed or treated. Psychiatric consultation was requested for 10 patients (19.2 percent) because of management problems, for diagnostic assessment, or by self-referral. Only one patient was given a psychiatric diagnosis at discharge. The results suggest that the neuropsychiatric complications of AIDS are underdiagnosed during acute medical illness and that psychiatric consultation is underutilized. AIDS patients have a heightened risk of psychological problems. Contributing factors may include the threat to life, severe physical debilitation, central nervous system involvement, fear of contagion, disclosure of homosexuality or drug abuse, and guilt associated with sexual transmission.
对纽约医院52例获得性免疫缺陷综合征（艾滋病）患者的病历进行了回顾性研究，以确定已记录的精神科并发症的患病率以及精神科会诊的使用情况。发现神经精神科并发症是急性病住院的艾滋病患者普遍存在的临床特征。绝大多数患者（82.7%）存在情绪障碍，65.4%的患者有器质性精神综合征（DSM-III）的体征；每位患者的病历中均提及神经精神科并发症。神经科并发症很少得到明确诊断或治疗。因管理问题、诊断评估或患者自行转诊，10例患者（19.2%）接受了精神科会诊。出院时只有1例患者获得了精神科诊断。结果表明，艾滋病的神经精神科并发症在急性内科疾病期间诊断不足，精神科会诊未得到充分利用。艾滋病患者存在心理问题的风险更高。促成因素可能包括对生命的威胁、严重的身体虚弱、中枢神经系统受累、对传染的恐惧、同性恋或药物滥用的暴露以及与性传播相关的内疚感。
