HIV-associated dementia is the most common neuropsychiatric problem found among persons infected with HIV. The authors review the research findings on HIV-associated dementia and discuss the pattern of cognitive changes characteristic of this disorder. An overview of the various organic mental disorders found in HIV-infected individuals and how they can be detected and differentiated from other neuropsychiatric illnesses, specifically HIV-associated dementia, is provided. This article provides the clinician with information necessary to detect HIV-associated dementia early, make a correct differential diagnosis, and provide the most effective mental health treatment services for this patient population.
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References
1.
Aerospace Medical Association Special Committee Report. (1992). HIV positivity and aviation safety. Aviation, Space, and Environmental Medicine, 63, 375–377.
2.
American Academy of Neurology AIDS Task Force. (1991). Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Neurology, 41, 778–785.
3.
AylwardE. H.HendererJ. D.McArthurJ. C.BrettschneiderP. D.HarrisG. J.BartaP. E., & PearlsonG. D. (1993). Reduced basal ganglia volume in HIV-1-associated dementia: Results from quantitative neuroimaging. Neurology, 43, 2099–2104.
4.
BoccellariA.DilleyJ. W., & ShoreM. D. (1988). Neuropsychiatric aspects of AIDS dementia complex: A report on a clinical series. Neurotoxicology, 9, 381–390.
5.
Bolla-WilsonK.RobinsonR. G.StarksteinS. E.BostonJ., & PriceT. R. (1989). Lateralization of dementia of depression in stroke patients. American Journal of Psychiatry, 146, 627–634.
6.
BuckinghamS. L., & Van GorpW. (1988). AIDS-dementia complex: Implications for practice. Social Casework, 69, 371–375.
7.
Centers for Disease Control. (1987). Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. Morbidity and Mortality Weekly Report (Supplement 1S), 3–15.
8.
CummingsJ. (1985). Clinical neuropsychiatry.New York: Oxford University Press.
9.
CummingsJ. (1990). Subcortical dementia.New York: Oxford University Press.
10.
DewhurstK.OliverJ.TrickK. L. K., & McKnightA. L. (1970). Sociopsychiatric consequences of Huntington's disease. British Journal of Psychiatry, 116, 255–258.
11.
DilleyJ. W.OchitillH. N.PerlM., & VolberdingP. (1985). Findings in psychiatric consultation with patients with acquired immune deficiency syndrome. American Journal of Psychiatry, 142, 82–86.
12.
GottliebM.SchroffR.SchankerH.WeismanJ.FanP.WolfR., & SaxonA. (1981). Pneumocystis carina pneumonia and mucosal candidiasis in previously healthy homosexual men: Evidence of a newly acquired cellular immunodeficiency. New England Journal of Medicine, 305, 1425–1430.
13.
GrantI.AtkinsonJ.HesselinkJ.KennedyC.RichmanD.SpectorS., & McCutchanJ. (1987). Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Annals of Internal Medicine, 107, 828–836.
14.
HinkinC.Van GorpW.SatzP.WeismanJ.ThommesJ., & BuckinghamS. (1992). Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. Journal of Clinical and Experimental Neuropsychology, 14, 289–297.
15.
HoD.RotaD.SchooleyR.KaplanJ.AllanJ.GroopmanJ.ResnickL.FelensteinD.AndrewsC., & HirschM. (1985). Isolation of HTLV-III from cerebrospinal fluid and neural tissue of patients with neurologic syndromes related to the acquired immunodeficiency syndrome. New England Journal of Medicine, 313, 1493–1497.
16.
MartinE. M.SorensenD. J.EdelsteinH. E., & RobertsonL. C. (1992). Decision-making speed in HIV-1 infection. AIDS, 6, 109–113.
17.
McArthurJ. C.HooverD. R.BacellarH.MillerE. N.CohenB. A.BeckerJ. T.GrahamN. M. H.McArthurJ. H.SeinesO. A.JacobsonL. P.VisscherB. R.ConchaM., & SaahA. (1993). Dementia in AIDS patients: Incidence and risk factors. Neurology, 43, 2245–2252.
18.
MillerE.SeinesO.McArthurJ.SatzP.BeckerJ.CohenB.SheridanK.MachadoA.Van GorpW., & VisscherB. (1990). Neuropsychological performance in HIV-1 infected homosexual men: The Multicenter AIDS Cohort Study (MACS). Neurology, 40, 197–203.
19.
NaviaB.ChoE. S.PetitoC., & PriceR. (1986). The AIDS dementia complex: II. Neuropathology. Annals of Neurology, 19, 525–535.
20.
NaviaB.JordanB., & PriceR. (1986). The AIDS dementia complex: I. Clinical features. Annals of Neurology, 19, 517–524.
21.
PerryS., & TrossS. (1984). Psychiatric problems of AIDS patients at the New York Hospital: Preliminary report. Public Health Reports, 39, 200–205.
22.
ResnickL.BergerJ. R.ShapshakP., & TourtellotteW. W. (1988). Early penetration of the blood–brain barrier by HIV. Neurology, 38, 9–14.
23.
ResnickL.de Marzio-VeroneseF.SchupbachJ.TourtellotteW.HoD.MullerF.ShapshakP.VogtM.GroopmanJ.MarkhamP., & GalloR. (1985). Intra-blood–brain-barrier synthesis of HTLV-III specific IgG in patients with neurological symptoms associated with AIDS or ARC. New England Journal of Medicine, 313, 1498–1504.
24.
RobinsonR.KubosK.StarrL.RaoK., & PriceT. (1984). Mood disorders in stroke patients: Importance of location of lesion. Brain, 107, 81–93.
25.
RottenbergD.MoellerJ.StrotherL.SidtisJ.NaviaB.DhawanV.GinosZ., & PriceR. (1987). The metabolic pathology of the AIDS dementia complex. Annals of Neurology, 22, 700–706.
26.
SaundersJ. M., & BuckinghamS. L. (1988). Suicidal AIDS patient: When the depression turns deadly. Nursing, 18, 59–64.
27.
SniderW.SimpsonD.NielsenS.GoldJ.MetrokaC., & PosnerJ. (1983). Neurological complications of acquired immune deficiency syndrome: Analysis of 50 patients. Annals of Neurology, 14, 403–418.
28.
Van GorpW.HinkinC.SatzP.MillerE., & D'EliaL. F. (1993). Neuropsychological findings in HIV infection, encephalopathy, and dementia. In ParksR.ZecR., & WilsonR. (Eds.), Neuropsychology of Alzheimer's disease and other dementias (pp. 153–185). New York: Oxford University Press.
29.
Van GorpW.SatzP.HinkinC.SeinesO.MillerN.McArthurJ.CohenB., & PazD. (1991). Metacognition in HIV-1 seropositive individuals: Self ratings versus objective neuropsychological performance. Journal of Clinical and Experimental Neuropsychology, 13, 812–819.
30.
WilkieF.EisdorferC.MorganR.LoewensteinD., & SzapocznikJ. (1990). Cognition in early HIV infection. Archives of Neurology, 47, 433–440.
31.
World Health Organization. (1988, March 17). Report of the consultation on the neuropsychiatric aspects of HIV infection.Geneva, Switzerland: Author.
