Psychopathology of first-episode psychosis in HIV-positive persons in comparison to first-episode schizophrenia: a neglected issue.
This study aims to detect different psychopathological dimensions in first-episode psychoses with different underlying causes. We evaluated 22 subjects with first-episode psychosis, who differed in biological variables (HIV-positive versus HIV-negative) and who were compared by using the Structured Clinical Interview for DSM-III-Reviewer, the 18-item Brief Psychiatric Rating Scale (BPRS), the 17-item Hamilton Depression Rating Scale, the 14-item Hamilton Anxiety Rating Scale and the Mini-Mental State Examination. HIV-positive subjects had higher mean scores on the global BPRS and on the paranoid Positive and Negative Syndrome Scale subscale compared with HIV-negative subjects. Conversely, higher prevalence of affective and anxious symptoms was found in the HIV-negative patients in comparison to HIV-positives. HIV-positives had significantly greater attention/concentration impairment than HIV-negative persons. In conclusion, taking into account psychopathological dimensions may help psychiatrists in clinical decision-making regarding the differential diagnosis of psychotic symptoms. The psychopathological pattern of first-episode psychosis in HIV-positive patients may represent an 'elementary model' of acute psychosis characterized by paranoid delusions in the absence of the usual affective symptoms.
De Ronchi
D
D
Institute of Psychiatry, University of Bologna, Bologna, Italy. deronchi@alma.unibo.it
Bellini
F
F
Cremante
G
G
Ujkaj
M
M
Tarricone
I
I
Selleri
R
R
Quartesan
R
R
Piselli
M
M
Scudellari
P
P
D000328:Adult; D010054:Brief Psychiatric Rating Scale; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000523:psychology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D008297:Male; D011599:Psychopathology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000209:etiology*; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis / Q000209:etiology*; D012959:Socioeconomic Factors