Primary Mania Versus HIV-Related  Secondary Mania in Uganda

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

doi:10.1176/ajp.2006.163.8.1349

Cited by 77 publications

(11 citation statements)

References 15 publications

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“…As has been observed in other studies in our setting [7], [24] mania, was the commonest presentation of psychosis. Among individuals with depression, the statistical difference observed in the HIV positive males and HIV negative males could be explained by the very low numbers of individual with the disorder.…”

Section: Discussionsupporting

confidence: 89%

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Cognitive Dysfunction among HIV Positive and HIV Negative Patients with Psychosis in Uganda

et al. 2012

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BackgroundCognitive impairment is an established phenomenon in HIV infected individuals and patients that have psychosis. However there is need to establish the severity of the impairment if patients are co morbid with both conditions.AimTo compare cognitive function among HIV positive individuals and HIV negative individuals with psychosis.MethodsWe recruited patients with psychosis at two national referral hospitals. A standardized demographics questionnaire and psychiatric, physical, and laboratory assessments were conducted. Types of psychosis were diagnosed using the Mini International Neuropsychiatric Inventory-PLUS while cognitive functioning was determined using the Mini mental state examination (MMSE) and a neuropsychological test battery. Follow-up assessments on cognitive function and severity of psychiatric illness were performed at 3 and 6 months. Pairwise comparison and multivariable logistic regression analysis were used to determine the differences between the HIV positive and HIV negative individuals.ResultsThere were 156 HIV positive and 322 HIV negative participants. The mean age was 33 years for the HIV positive group and 29 years for the HIV negative group (p<0.001). The HIV positive individuals were almost three times (OR = 2.62 CI 95% 1.69–4.06) more likely to be cognitively impaired on the MMSE as well as the following cognitive tests:- WHO-UCLA Auditory Verbal Learning Test (OR 1.79, 95% CI 1.09–2.92), Verbal Fluency (OR 3.42, 95% CI 2.24–5.24), Color Trails 1 (OR 2.03, 95% CI 1.29–3.02) and Color Trails 2 (OR 3.50 95% 2.00–6.10) all p = 0.01. There was improvement in cognitive function at follow up; however the impairment remained higher for the HIV positive group (p<0.001).ConclusionCognitive impairment in psychosis was worsened by HIV infection. Care plans to minimize the effect of this impairment should be structured for the management of individuals with HIV and psychosis.

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Section: Discussionsupporting

confidence: 89%

“…In many patients the cognitive impairment is not secondary to delusions or effects of hallucinations but may rise from the lack of motivation the patients experience [4]. Though cognitive dysfunction does not occur in all patients with psychosis [5], the dysfunction is common among patients with HIV associated psychosis, [6], [7].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Dysfunction among HIV Positive and HIV Negative Patients with Psychosis in Uganda

et al. 2012

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“…The association between major depressive disorder and younger age contradicts previous studies where major depressive disorder was particularly common in older people attending PHC services [35], [36], [51]. Perhaps the different contexts in which HIV/AIDS manifests could explain such differences.…”

Section: Discussioncontrasting

confidence: 73%

“…The MINI has been used in a number of studies as a diagnostic instrument among PLWHA in Uganda [7], [35], [36], [40].…”

Section: Methodsmentioning

confidence: 99%

The Association between Aids Related Stigma and Major Depressive Disorder among HIV-Positive Individuals in Uganda

et al. 2012

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BackgroundMajor depressive disorder in people living with HIV/AIDS (PLWHA) is common and may be associated with a number of factors, including AIDS-related stigma, decreased CD4 levels, increased opportunistic infections and sociodemographic variables. The extent to which AIDS-related stigma is associated with major depressive disorder among PLWHA has not been well studied in sub-Saharan Africa. The objective of this study was to examine the associations between major depressive disorder, AIDS-related stigma, immune status, and sociodemographic variables with the aim of making recommendations that can guide clinicians.MethodsWe assessed 368 PLWHA for major depressive disorder, as well as for potentially associated factors, including AIDS-related stigma, CD4 levels, presence of opportunistic infections, and sociodemographic variables.ResultsThe prevalence of major depressive disorder was 17.4%, while 7.9% of the participants had AIDS related stigma. At multivariable analysis, major depressive disorder was significantly associated with AIDS-related stigma [OR = 1.65, CI (1.20–2.26)], a CD4 count of ≥200 [OR 0.52 CI (0.27–0.99)], and being of younger age [0.95, CI (0.92–0.98).ConclusionsDue to the high burden of major depressive disorder, and its association with AIDS related stigma, routine screening of PLWHA for both conditions is recommended. However, more research is required to understand this association.

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“…Again, this must be disentangled from a pre-existing bipolar disorder, or a reaction to drugs. So-called “secondary” or AIDS mania tends to occur in patients with poorly controlled disease, concurrent cognitive deficits, irritability, aggression, and talkativeness, and have hallucinations and paranoia {31}.…”

Section: Hiv Associated Neurocognitive Disorders (Hand)mentioning

confidence: 99%

Neurologic Presentations of AIDS

Singer¹,

Valdes-Sueiras²,

Commins³

et al. 2010

Neurologic Clinics

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The human immunodeficiency virus (HIV), the cause of AIDS, has infected an estimated 33 million individuals worldwide. HIV is associated with immunodeficiency, neoplasia, and neurologic disease. The continuing evolution of the HIV epidemic has spurred an intense interest in a hitherto neglected area of medicine, neuroinfectious diseases and their consequences. This work has broad applications for the study of central nervous system (CNS) tumors, dementias, neuropathies, and CNS disease in other immunosuppressed individuals. HIV is neuroinvasive (can enter the CNS), neurotrophic (can live in neural tissues), and neurovirulent (causes disease of the nervous system). This article reviews the HIV-associated neurologic syndromes, which can be classified as primary HIV neurologic disease (in which HIV is both necessary and sufficient to cause the illness), secondary or opportunistic neurologic disease (in which HIV interacts with other pathogens, resulting in opportunistic infections and tumors), and treatment-related neurologic disease (such as immune reconstitution inflammatory syndrome).

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Primary Mania Versus HIV-Related Secondary Mania in Uganda

Cited by 77 publications

References 15 publications

Cognitive Dysfunction among HIV Positive and HIV Negative Patients with Psychosis in Uganda

Cognitive Dysfunction among HIV Positive and HIV Negative Patients with Psychosis in Uganda

The Association between Aids Related Stigma and Major Depressive Disorder among HIV-Positive Individuals in Uganda

Neurologic Presentations of AIDS

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