Somatic Treatment of Psychiatric Symptoms in HIV Disease

  • Katie A. Busch
  • Sarz Maxwell


In June 1981, the Morbidity and Mortality Weekly Report published an account of five homosexual men infected with Pneumocystis carinii pneumonia (PCP).1 As case reports mounted of PCP, of previously rare Kaposi’s sarcoma (KS), and of other opportunistic infections,2 the symptom cluster was given the name acquired immune deficiency syndrome (AIDS). In 1983, a retrovirus was isolated that is currently believed to be etiologic in AIDS, which now carries the official name human immunodeficiency virus (HIV). After a brief introduction on HIV illness in general, we review the literature to date on its neuropsychiatric aspects, with a major focus on the complicated diagnostic and treatment issues at this interface. Psychosocial issues3,4 so essential in treatment, are described elsewhere in this volume and are beyond the scope of this chapter.


Human Immunodeficiency Virus Immune Deficiency Syndrome Anticholinergic Side Effect Somatic Treatment Primary Human Immunodeficiency Virus Infection 
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  1. 1.
    Centers for Disease Control: Pneumocystis pneumonia—Los Angeles. MMWR 30: 250–252, 1981.Google Scholar
  2. 2.
    Centers for Disease Control: Kaposi’s sarcoma and Pneumocystis pneumonia among homosexual men—New York City and California. MMWR 30: 305–307, 1981.Google Scholar
  3. 3.
    Holland JC, Tross S: The psychosocial and neuropsychiatric sequelae of the acquired immunodeficiency syndrome and related disorders. Ann Intern Med 103: 760–764, 1985.PubMedCrossRefGoogle Scholar
  4. 4.
    Nichols SE: Psychosocial reactions of persons with the acquired immunodeficiency syndrome. Ann Intern Med 103: 765–767, 1985.PubMedCrossRefGoogle Scholar
  5. 5.
    Centers for Disease Control: Weekly Surveillance Report 1/11/88, AIDS Rec 2 (3): 6, 1988.Google Scholar
  6. 6.
    Di Clemente RJ, Boyer CB, Morales ES: Minority and AIDS: Am J Public Health 78: 55–57, 1988.CrossRefGoogle Scholar
  7. 7.
    Centers for Disease Control: Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 36 (suppl): 15, 1987.Google Scholar
  8. 8.
    Price RW, Navia BA, Cho E-S: AIDS encephalopathy. Neurol Clin 4: 285–303, 1986.PubMedGoogle Scholar
  9. 9.
    Faulstich ME: Acquired immune deficiency syndrome: An overview of the central nervous system complications and neuropsychological sequelae. Int J Neurosci 30: 249–254, 1986.PubMedCrossRefGoogle Scholar
  10. 10.
    Snider WD, Simpson DM, Nielson S, et al: Neurological complications of acquired immune deficiency syndrome: Analysis of 50 patients. Ann Neural 14: 403–418, 1983.CrossRefGoogle Scholar
  11. 11.
    Fernandez F, Adams F, Levy JK, et al: Cognitive impairment due to AIDS-related complex and its response to psychostimulants. Psychosomatics 29: 38–46, 1988.PubMedCrossRefGoogle Scholar
  12. 12.
    Perry S, Jacobsen P: Neuropsychiatric manifestations of AIDS-spectrum disorders. Hasp Community Psychiatry 37: 135–142, 1986.Google Scholar
  13. 13.
    Navia BA, Jordan BD, Price RW: The AIDS dementia complex. I. Clinical Features. Ann Neurol 19: 517524, 1986.Google Scholar
  14. 14.
    Navia BA, Price RW: The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection. Arch Neurol 44: 65–66, 1987.PubMedCrossRefGoogle Scholar
  15. 15.
    Beckett A, Summergrad P, Manschreck T, et al: Symptomatic HIV infection of the CNS in a patient without clinical evidence of immune deficiency. Am J Psychiatry 144: 1342–1344, 1987.PubMedGoogle Scholar
  16. 16.
    Detmer WM, Lu FG: Neuropsychiatrie complications of AIDS: A literature review. Int J Psychiatry Med 16:21–29, 1986–1987.Google Scholar
  17. 17.
    Folstein MF, Folstein SE, McHugh PR: “Mini-Mental State.” J Psychiatr Res 12: 189–198, 1975.PubMedCrossRefGoogle Scholar
  18. 18.
    Reitan RM: The relation of the Trail-making test to organic brain damage. J Consult Psychol 19: 393–394, 1955.PubMedCrossRefGoogle Scholar
  19. 19.
    Davies ADM: The influence of age on Trail-making test performance. J Clin Psychol 24: 96–98, 1968.PubMedCrossRefGoogle Scholar
  20. 20.
    Shaw GM, Harper ME, Hahn BH, et al: HTLV-III infection in brains of children and adults with AIDS encephalopathy. Science 227: 177–181, 1985.PubMedCrossRefGoogle Scholar
  21. 21.
    Belman AL, Ultmann MH, Horoupian D, et al: Neurological complications in infants and children with acquired immune deficiency syndrome. Ann Neurol 18: 560–566, 1985.PubMedCrossRefGoogle Scholar
  22. 22.
    Navia BA, Petito CK, Gold JWM, et al: Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: Clinical and neuropathological findings in 27 patients. Ann Neurol 19: 224–238, 1986.PubMedCrossRefGoogle Scholar
  23. 23.
    Navia BA, Cho E-S, Petito CK, Price RW: The AIDS dementia complex. II. Neuropathology Ann Neurol 19: 525–535, 1986.CrossRefGoogle Scholar
  24. 24.
    Nielson SL, Petito CK, Urmacher CD, et al: Subacute encephalitis in the acquired immune deficiency syndrome: A postmortem study. Am J Clin Pathol 82: 678–682, 1984.Google Scholar
  25. 25.
    Epstein LG, Sharer LR, Joshi VV, et al: Progressive encephalopathy in children with acquired immune deficiency syndrome. Arch Neurol 17: 488–496, 1985.Google Scholar
  26. 26.
    Stoler MH, Eskin TA, Benn S, et al: Human T-cell lymphotropic virus type III infection of the central nervous system. A preliminary in situ analysis. JAMA 256: 2360–2364, 1986.PubMedCrossRefGoogle Scholar
  27. 27.
    Perry SW, Tross S: Psychiatric problems of AIDS inpatients at the New York Hospital: Preliminary report. Public Health Rep 99: 200–205, 1984.PubMedGoogle Scholar
  28. 28.
    Rundell JR, Wise MG, Ursano RJ: Three cases of AIDS-related psychiatric disorders. Am J Psychiatry 143: 777–778, 1986.PubMedGoogle Scholar
  29. 28a.
    Strain J: Paper presented at the May 1987 American Psychiatric Association Meeting, New York, May, 1987.Google Scholar
  30. 29.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised. Washington, DC, American Psychiatric Association, 1987.Google Scholar
  31. 30.
    Clark DC, Cavanaugh SVA, Gibbons RD: The core symptoms of depression in medical and psychiatric patients. J New Ment Dis 171: 705–713, 1983.CrossRefGoogle Scholar
  32. 31.
    Cummings JL: Organic psychosis. Psychosomatics 29: 16–26, 1988.PubMedCrossRefGoogle Scholar
  33. 32.
    Physicians’ Desk Reference, ed 42. Oradell, New Jersey, Medical Economics Company, 1988.Google Scholar
  34. 33.
    Schnoll SH: Pain. in Buchwald C, Cohen S, Katz D, Solomon J (eds): Frequently Prescribed and Abused Drugs. State University of New York, 1980.Google Scholar
  35. 34.
    Perry SW, Markowitz J: Psychiatric interventions of AIDS-spectrum disorders. Hosp Community Psychiatry 37: 1001–1006, 1986.PubMedGoogle Scholar
  36. 35.
    Reynolds CF, Maren RS, Spiker D: Clinical considerations in prescribing antidepressants for geriatric patients. Geriatr Med Today 2: 45–55, 1983.Google Scholar
  37. 36.
    Baer JW, Hall JM, Holm K, et al: Challenges in developing an outpatient psychiatric program for patients with AIDS and ARC. Hosp Community Psychiatry 38: 1299–1303, 1987.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Katie A. Busch
    • 1
  • Sarz Maxwell
    • 1
  1. 1.Department of PsychiatryRush—Presbyterian—St. Luke’s Medical CenterChicagoUSA

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