Early-onset versus late-onset HIV-related secondary mania in Uganda

Psychosomatics. 2008 Nov-Dec;49(6):530-4. doi: 10.1176/appi.psy.49.6.530.

Abstract

Background: First-episode secondary mania in human immunodeficiency virus (HIV) infection has been described among samples of predominantly Caucasian, HIV-positive male patients in developed countries.

Objective: The goal of this study was to compare the demographic and clinical characteristics of HIV-positive patients with early-onset and late-onset first-episode secondary mania in HIV infection. There were previous findings of an association between late-onset mania and severe cognitive impairment.

Method: Subjects were HIV inpatients with clinically-confirmed mania, who received standard demographic, psychiatric, physical, and laboratory assessments. Early-onset patients had CD4 cell counts > 200 mm(3); late-onset patients had CD4 cell counts < or = 200 mm(3).

Results: There were no demographic or cognitive differences between early-onset and late-onset mania patients, and high rates of psychotic symptoms in both groups. However, late-onset patients had more manic symptoms.

Conclusion: Late-onset HIV mania patients had more severe psychopathology and, thus, demonstrated a greater need for highly active retroviral therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Dementia Complex / epidemiology
  • AIDS Dementia Complex / psychology
  • Adolescent
  • Adult
  • Age Distribution
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / psychology
  • CD4 Lymphocyte Count
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology
  • Comorbidity
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology
  • Severity of Illness Index
  • Sex Distribution
  • Socioeconomic Factors
  • Uganda / epidemiology
  • Young Adult