Syphilis in psychiatric inpatients: prevalence, treatment, and implications

Hutto, Burton; Adimora, Adaora A.

doi:10.1016/s0163-8343(00)00088-8

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…Similar cases can be found for alcohol dependence (e.g. Cnossen et al, 1995;Blatz et al, 2005;Hutto, 2000). These cases show in particular the eventual co-incidence of a syphilis infection and psychiatric disorders.…”

Section: Psychiatric Manifestations Of Neurosyphilissupporting

confidence: 61%

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Psychiatric Manifestations of Neurosyphilis

Friedrich¹,

Aigner²

2011

Syphilis - Recognition, Description and Diagnosis

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Section: Psychiatric Manifestations Of Neurosyphilissupporting

confidence: 61%

“…A few case reports on substance dependence in association with neurosyphilis are available. Hutto (2001Hutto ( , 2000 reports of a patient initially treated for cocaine dependency, depression, and psychotic symptoms. Initial syphilis screening detected the eventual presence of neurosyphilis.…”

Section: Psychiatric Manifestations Of Neurosyphilismentioning

confidence: 99%

Psychiatric Manifestations of Neurosyphilis

Friedrich¹,

Aigner²

2011

Syphilis - Recognition, Description and Diagnosis

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“…Manifestations of schizophrenia-like symptoms due to neurosyphilis can also be found [26,34,35,36,37]. Friedrich et al [38] report an improvement in the psychotic symptoms of neurosyphilis due to penicillin therapy.…”

Section: Resultsmentioning

confidence: 99%

“…The evidence indicates that an increase in infection rates in industrialized countries of the Western world can be observed too. Taking into account that due to the diversity of clinical manifestations of neurosyphilis it is impossible to carry out a diagnosis only based on the analysis of clinical symptoms, blood screening for syphilis in the psychiatric field seems to be a vital part of diagnostic investigation of psychiatric patients [10,34]. Every patient with clinically evident psychiatric symptoms should have bloodscreening for syphilis, and in the case of positive results a lumbar puncture is indicated.…”

Section: Discussionmentioning

confidence: 99%

Psychosis in Neurosyphilis - Clinical Aspects and Implications

et al. 2013

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Background: The World Health Organization estimates that 10-12 million new syphilis infections occur each year. Without treatment, years to decades after initial infection, 30% of affected individuals may develop tertiary syphilis, which can manifest as neurosyphilis. The aim of this review is to evaluate the research literature examining the psychopathological manifestations of psychosis in association with neurosyphilis. Method: The authors performed a systematic electronic search for published studies (1995-2012). The following databases were used: Medline, Embase and the Cochrane Library as well as the search engines Scopus and Google Scholar. Results: 61 articles were used for detailed analysis. Psychotic symptoms due to neurosyphilis are numerous and can inform differential diagnosis for many psychotic manifestations according to ICD-10 or DSM-IV. Conclusion: Due to our results, current epidemiological data, and the difficulties in differential diagnosis of neurosyphilis, routine screening tests are still recommended in the psychiatric field. Long-term psychiatric input, with periodic syphilis titre controls, seems indicated in individuals affected by neurosyphilis with psychiatric symptoms. Furthermore, individuals with mental health problems may be at higher risk of acquiring syphilis.

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“…The 11.7% prevalence among psychiatric patients was lower than that found by other authors, but higher than anticipated. 9,14 It is unknown whether the prevalence is comparable in local psychiatric hospitals. The statistical insignificance of the slightly lower syphilis prevalence in the male long-term group could reflect the high-risk sexual behaviour that was not statistically significantly different between the groups.…”

Section: Discussionmentioning

confidence: 99%

Syphilis sero-positivity in recently admitted and long-term psychiatric inpatients: Screening, prevalence and diagnostic profile

2012

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Background. Syphilis research has neglected the prevalence of the disease among psychiatric patients, and traditional syphilis screening has been reported as inadequate.Objectives. (i) To assess the syphilis prevalence among psychiatric patients; (ii) to compare psychiatric diagnoses of syphilis-infected and -uninfected patients; (iii) to assess self-reported high-risk sexual behaviour; (iv) to establish syphilis/HIV co-morbidity; and (v) to investigate the performance of the rapid plasma reagin (RPR) test in syphilis screening, compared with the Treponema pallidum haemagglutination (TPHA) test.Methods. Psychiatric inpatients at Weskoppies Hospital, Pretoria, who consented to participate in the study (N=195) were categorised according to gender and length of admission (long-term or recent). Non-treponemal RPR, confirmatory TPHA, HIV-rapid and HIV enzyme-linked immunosorbent assay (ELISA) tests were performed. A reactive TPHA test was used to diagnose syphilis. Results. The estimated prevalence of syphilis was 11.7%. There was no significant association between TPHA sero-positivity and primary psychiatric diagnosis or self-reported high-risk sexual behaviour. Significant co-morbidity existed between syphilis and HIV (p=0.012). Compared with the TPHA test, the RPR test performed poorly, identifying only 2/23 patients who had a sero-positive TPHA test (8.7% sensitivity and 100% specificity).Conclusions. The prevalence of syphilis was higher than anticipated, supporting the need for routine testing. The significant co-morbidity and alarming prevalence of HIV and syphilis warrant testing for both conditions in all psychiatric admissions. Current syphilis screening with a single RPR test is inadequate; both RPR and TPHA tests should be performed.

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Syphilis in psychiatric inpatients: prevalence, treatment, and implications

Cited by 10 publications

References 8 publications

Psychiatric Manifestations of Neurosyphilis

Psychiatric Manifestations of Neurosyphilis

Psychosis in Neurosyphilis - Clinical Aspects and Implications

Syphilis sero-positivity in recently admitted and long-term psychiatric inpatients: Screening, prevalence and diagnostic profile

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