HIV-associated psychosis: a study of 20 cases. San Diego HIV Neurobehavioral Research Center Group

Am J Psychiatry. 1994 Feb;151(2):237-42. doi: 10.1176/ajp.151.2.237.


Objective: Psychosis is an uncommon but serious complication of infection with HIV. This article presents the results of a study of HIV-infected individuals with psychosis.

Method: The authors evaluated 20 HIV-infected men who had noniatrogenic new-onset psychosis without delirium, current substance abuse, or previous psychotic episodes. Clinical, neuropsychological, CSF, magnetic resonance imaging, and neuropathologic assessments were made. A comparison group consisting of 20 nonpsychotic HIV-infected men matched to the psychotic subjects with respect to age, race, years of education, and Centers for Disease Control HIV stage was also evaluated.

Results: The psychotic patients differed from the nonpsychotic comparison subjects in having significantly higher rates of past stimulant and sedative/hypnotic abuse or dependence and, at follow-up, a significantly higher rate of mortality. They also showed a trend toward greater global neuropsychological impairment.

Conclusions: New-onset psychosis may be, at least in part, a manifestation of an HIV-associated encephalopathy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Dementia Complex / diagnosis
  • AIDS Dementia Complex / epidemiology
  • Adolescent
  • Adult
  • Comorbidity
  • Diagnosis, Differential
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurocognitive Disorders / diagnosis
  • Neurocognitive Disorders / epidemiology
  • Neuropsychological Tests
  • Prevalence
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / epidemiology
  • Substance-Related Disorders / epidemiology