A neuropsychiatric program for HIV-infected individuals.

Designing an effective, outpatient, community-based neuropsychiatric program for persons infected with human immunodeficiency virus-1 (HIV) is challenging because the affected population is diverse. The individuals must cope with a multitude of complications while anticipating a shortened life span. Behavioral and emotional complications are common and may be reactive, idiopathic, or organic. An effective program must provide neuropsychiatric evaluations and give access to ongoing supportive and psychotherapeutic services that take into account problems unique to HIV-infected individuals. Neuropsychiatric evaluations were performed on 80 infected patients. The HIV-seropositive individuals (n = 60) were compared with patients with acquired immunodeficiency syndrome (AIDS) (n = 20) using several clinical measures. Patients in the early stages of HIV infection suffered from more frequent major depressive episodes and ongoing substance abuse than patients with advanced disease. Cognitive impairment and psychosis, however, were primarily related to AIDS.