Clinical Presentation of Bipolar Mania in HIV-Positive Patients in Uganda

Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Mpungu, Steven Kiwuwa; Katabira, Elly

doi:10.1176/appi.psy.50.4.325

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…The general thinking is that mania in the early stages of HIV in individuals with a history of mood disorder and a CD4 count greater than 200 is indicative of bipolar disorder. In contrast, manic symptoms thought to be related to the HIV virus in the brain in the later stages of AIDS, with CD4 counts less than 200, are descriptive of secondary mania (Nakimuli-Mpungu et al 2009). Bipolar mania and secondary mania should be characterized as different conditions, as they have distinct clinical presentations and management.…”

Section: Psychiatric Illnesses In Older Hiv Patientsmentioning

confidence: 99%

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Neuropsychiatric complications of aging with HIV

Watkins

Treisman

2012

J. Neurovirol.

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Persons over age 50 are not only aging with human immunodeficiency virus (HIV) infection but also represent a high proportion of new HIV infections. Neuropsychiatric symptoms, including depression, cognitive impairment, and substance abuse, are very common in individuals infected with HIV. However, there is little understanding of the relationship between these HIV-related comorbid conditions in newly infected elderly patients compared to uninfected elderly and those who have survived after 20 years of HIV/AIDS. We summarize the current theories and research that link aging and HIV with psychiatric illnesses and identify emerging areas for improved research, treatment, and patient care.

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Section: Psychiatric Illnesses In Older Hiv Patientsmentioning

confidence: 99%

“…HIV-positive patients with bipolar disorder were older than the HIV-negative patients. This suggests that the HIV-positive patients had a longer duration of bipolar illness than the HIV-negative patients with bipolar mania (Nakimuli-Mpungu et al 2009). …”

Section: Psychiatric Illnesses In Older Hiv Patientsmentioning

confidence: 99%

Neuropsychiatric complications of aging with HIV

Watkins

Treisman

2012

J. Neurovirol.

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“…In addition, MDD in HIV accelerates the rate of decline of cognitive symptoms, and is associated with higher deficits in comprehension, attention, and memory [41,50]. Manic symptoms in the early stages of HIV and a CD4 count >200 is indicative of BD [51,52]. A neurological symptom of late-stage HIV/AIDS, when the CD4 counts are <200 is the onset of psychosis in patients, which is postulated to be due to CNS infection, tumors, HIV invasion into the brain, and cognitive impairment [53].…”

Section: Discussionmentioning

confidence: 99%

Is the History of Substance Abuse Correlated with Neuropsychiatric Disorders and Co-morbid HIV Infection? An Urban Population Study

Bassey¹,

Chapman²,

Pessu³

et al. 2018

J Neurol Neurosci

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Background Human immunodeficiency virus (HIV) infection remains a serious immunological disease with new infections in the U.S. disproportionately reported in minority populations. For many years, the District of Columbia (DC) has reported the highest HIV infection rate in the nation. Drug abuse and addiction is also prevalent in DC and has traditionally been linked to HIV/AIDS because of the likelihood for opportunistic infections. Despite this data, the relationship between HIV status, drugs of abuse, and the incidence of neurological disorders are scarcely reported for minority populations. Method We carried out a retrospective study on the prevalence of substance abuse in HIV and their association with neuropsychiatric comorbidities in an African American subpopulation in Washington DC. Findings Our data suggests an 86 percent prevalence of drug use in the HIV patients with neuropsychiatric comorbidities, with cocaine use being significantly higher in patients with major depressive disorder (MDD) and bipolar disorder (BD), whereas PCP use was associated with patients with schizophrenia. The mean CD4 count was elevated in patients with neuropsychiatric disease, and specifically in MDD patients. CD8 counts were elevated as expected for HIV status but were not influenced by disease diagnosis. A majority (2/3) of patients were on HAART therapy, however the records did not account for adherence. Conclusion These data suggest that neuropsychiatric comorbidities are independent of HIV disease progression but are correlated with certain illicit drugs of abuse.

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“…These problems may be pre-existing mental illnesses in an individual who becomes secondarily infected with HIV or they may develop because of the direct or indirect effects of the HIV virus on the brain 6. For example, we have previously described the clinical presentation of individuals with acute mania and HIV infection 7. Our research has shown that such individuals could have HIV-related secondary mania or bipolar disorder mania.…”

Section: Introductionmentioning

confidence: 87%

Effect of HIV infection on time to recovery from an acute manic episode

Nakimuli-Mpungu

Mutamba²,

Nshemerirwe³

et al. 2010

HIV

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IntroductionUnderstanding factors affecting the time to recovery from acute mania is critical in the management of manic syndromes. The aim of this study was to determine the effect of HIV infection on time to recovery from acute mania.MethodsWe performed a retrospective study in which medical charts of individuals who were treated for acute mania were reviewed. Survival analysis with Cox regression models were used to compare time to recovery from an acute manic episode between human immunodeficiency virus (HIV)-positive individuals and HIV-negative individuals.ResultsMedian survival time was one week for HIV-positive individuals and more than four weeks for HIV-negative individuals (χ2 = 18.4, P value = 0.000). HIV infection was the only marginally significant independent predictor of survival probability on the acute admission ward (hazards ratio 2.87, P = 0.06).ConclusionAcute mania in HIV-infected persons responds faster to psychotropic drugs compared with that in HIV-negative persons.

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Clinical Presentation of Bipolar Mania in HIV-Positive Patients in Uganda

Cited by 20 publications

References 19 publications

Neuropsychiatric complications of aging with HIV

Neuropsychiatric complications of aging with HIV

Is the History of Substance Abuse Correlated with Neuropsychiatric Disorders and Co-morbid HIV Infection? An Urban Population Study

Effect of HIV infection on time to recovery from an acute manic episode

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