Sewell D D, Jeste D V, Atkinson J H, Heaton R K, Hesselink J R, Wiley C, Thal L, Chandler J L, Grant I
Department of Psychiatry, School of Medicine, University of California, San Diego.
Am J Psychiatry. 1994 Feb;151(2):237-42. doi: 10.1176/ajp.151.2.237.
Psychosis is an uncommon but serious complication of infection with HIV. This article presents the results of a study of HIV-infected individuals with psychosis.
The authors evaluated 20 HIV-infected men who had noniatrogenic new-onset psychosis without delirium, current substance abuse, or previous psychotic episodes. Clinical, neuropsychological, CSF, magnetic resonance imaging, and neuropathologic assessments were made. A comparison group consisting of 20 nonpsychotic 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.
The psychotic patients differed from 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 showed a trend toward greater global neuropsychological impairment.
New-onset psychosis may be, at least in part, a manifestation of an HIV-associated encephalopathy.
精神病是感染人类免疫缺陷病毒（HIV）后一种不常见但严重的并发症。本文介绍了一项针对感染HIV且患有精神病患者的研究结果。
作者评估了20名感染HIV的男性，这些男性患有非医源性新发精神病，无谵妄、当前药物滥用或既往精神病发作史。进行了临床、神经心理学、脑脊液、磁共振成像和神经病理学评估。还评估了一个由20名未患精神病的感染HIV男性组成的对照组，该对照组在年龄、种族、受教育年限和疾病控制中心HIV分期方面与患精神病的受试者相匹配。
患精神病的患者与未患精神病的对照受试者不同，既往兴奋剂和镇静/催眠药滥用或依赖的发生率显著更高，且在随访中死亡率显著更高。他们还呈现出整体神经心理学损害更严重的趋势。
新发精神病可能至少部分是HIV相关脑病的一种表现。
