Two cases of mania in homosexual men with AIDS are presented. Particular emphasis is placed on the psychodynamic and psychosocial factors thought to be aetiologically significant. AIDS is seen both as an example of a terminal illness, and also as creating unique difficulties. It is suggested that integrative rather than reductionist thinking is needed in cases which under DSM-Ill-R would simply be classified as “organic mood disorder”, that is, that all causal and contributory factors need to be considered in affective disorder occurring in the physically ill.
References
1.
LarsonEWRichelsonE. Organic causes of mania. Mayo Clinic Proceedings1988; 63: 906–912.
2.
CummingsJL. Organic psychoses. Delusional disorders and secondary mania. Psychiatric Clinics of North America1986; 9: 293–311.
3.
KrauthammerCKlermanGL. Secondary mania. Manic syndromes associated with antecedent physical illness or drugs. Archives of General Psychiatry1978; 35: 1333–1339.
4.
ShuklaSCookBLMukherjeeSGodwinCMillerMG. Mania following head trauma. American Journal of Psychiatry1987; 144: 93–96.
5.
ClarkAFDavisonK. Mania following head injury. A report of two cases and a review of the literature. British Journal of Psychiatry1987; 150: 841–844.
6.
CummingsJLMendezMF. Secondary mania with focal cerebrovascular lesions. American Journal of Psychiatry1984; 141: 1084–1087.
7.
StarksteinSERobinsonRG. Affective disorders and cerebral vascular disease. British Journal of Psychiatry1989; 154: 170–182.
8.
JamiesonRCWellsCE. Manic psychosis in a patient with multiple metastatic brain tumors. Journal of Clinical Psychiatry1979; 40: 280–283.
9.
JoffeRTLippertGPGrayTASawaGHorvathZ. Mood disorder and multiple sclerosis. Archives of Neurology1987; 44: 376–378.
10.
HenryFlor P. Schizophrenic-like reactions and affective psychoses associated with temporal lobe epilepsy: Etiological factors. American Journal of Psychiatry1969; 126: 400–404.
11.
HallRCWPopkinMKStickneySKGardnerER. Presentation of the steroid psychoses. Journal of Nervous and Mental Disease1979; 167: 229–236.
12.
LewisDASmithRE. Steroid induced psychiatric syndromes. A report of 14 cases and a review of the literature. Journal of Affective Disorders1983; 5: 319–332.
13.
CoidJStrangJ. Mania secondary to procyclidine (‘Kemadrin’) abuse. British Journal of Psychiatry1982; 141: 81–84.
14.
RitchieKSPreskornSH. Mania induced by metoclopramide. Case report. Journal of Clinical Psychiatry;1984; 45: 180–181.
15.
AranaGWPearlmanCShaderRI. Alprazolam-induced mania: two clinical cases. American Journal of Psychiatry1985; 142: 368–369.
16.
BuhrichNCooperDAFreedE. HIV infection associated with symptoms indistinguishable from functional psychosis. British Journal of Psychiatry1988; 152: 649–653.
17.
SchmidtUMillerD. Two cases of hypomania in AIDS. British Journal of Psychiatry1988; 152: 839–842.
18.
GabelRHBarnardNNorkoMO'ConnellRA. AIDS presenting as mania. Comprehensive Psychiatry1986; 27: 251–254.
19.
NurnbergHGPrudicJFioriMFreedmanEP. Psychopathology complicating acquired immune deficiency syndrome (AIDS). American Journal of Psychiatry1984; 141: 95–96.
20.
MaxwellSScheftnerWAKesslerH. Manic syndromes associated with zydovudine treatment. Journal of the American Medical Association1988; 259: 3406–3407.
21.
WrightJMSachdevPSPerkinsRJRodriguezP. Zydovudine-related mania. Medical Journal of Australia1989; 150: 339–341.
22.
NaviaBAPriceRW. The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus. Archives of Neurology1987; 44: 65–69.
23.
BoccelariADilleyJWShoreMD. Neuropsychiatric aspects of AIDS dementia complex: a report on a clinical series. Neurotoxicology1988; 9: 381–390.
24.
GrantIAtkinsonJHHesselinkJRKennedyCJRichmondDDSpectorSAMcCutchanJA. Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Annals of Internal Medicine1987; 107: 828–836.
25.
NaviaBAJordanBDPriceRW. The AIDS dementia complex: 1. Clinical features. Annals of Neurology1986; 19: 517–524.
26.
NaviaBAChoESPetitoCKPriceRW. The AIDS dementia complex: II Neuropathology. Annals of Neurology1986; 19: 525–535.
27.
NicholsSE. Psychosocial reactions of persons with the acquired immunodeficiency syndrome. Annals of Internal Medicine1985; 103: 765–767.
28.
CohenMAA. Biopsychosocial approach to the human immunodeficiency virus epidemic. A clinician's primer. General Hospital Psychiatry1990; 12: 98–123.
29.
AmbelasA. Causable mania (reactive, puerperal, secondary, life event related). The development of an idea. Acta Psychiatrica Scandinavica1987; 75: 225–230.
30.
KleinM. Mourning and its relation to manic-depressive states. International Journal of Psychoanalysis1940; 21: 125–153.
31.
ParkesCM. Recent bereavement as a cause of mental illness. British Journal of Psychiatry1964; 110: 198–204.
32.
RickarbyGA. Four cases of mania associated with bereavement. Journal of Nervous and Mental Disease1977; 165: 255–262.
33.
HollenderMHGoldinML. Funeral mania. Journal of Nervous and Mental Disease1978; 166: 890–892.
34.
FreudS. Some neurotic mechanisms in jealousy, paranoia and homosexuality. In The Standard Edition of the complete psychological works of Sigmund Freud Volume XVIII. London: The Hogarth Press1955.
35.
FenichelO. The psychoanalytic theory of neurosis. New York: Norton1945.
36.
SilbersteinLRMishkindMEStriegel-MooreRHTimkoCRodinJ. Men and their bodies: A comparison of homosexual and heterosexual men. Psychosomatic Medicine1989; 51: 337–346.
37.
AkhtarS. Narcissistic personality disorder. Descriptive features and differential diagnosis. In: The Psychiatric Clinics of North America1989; 12: 3: 505–529.
38.
JohnsonSM. Humanizing the narcissistic style. New York, London: Norton, 1987.
39.
WeismanA. On dying and denying: a psychiatric study of terminality. New York: Behavioral Publications Inc., 1972.
40.
Kubler-RossE. On death and dying. New York: The MacMillan Company, 1964.
41.
SontagS. AIDS and its metaphors. New York: Farrar, Straus and Giroux, 1989.
42.
AltmanD. AIDS and the new puritanism. London: Pluto Press, 1986.
43.
FogelBS. Major depression versus organic mood disorder: a questionable distinction. Journal of Clinical Psychiatry1990; 51: 53–56.
44.
McCuneWJGolbusJ. Neuropsychiatric Lupus. Rheumatic Disease Clinics of North America1988; 14: 149–167.
