Early-onset versus late-onset HIV-related secondary mania in Uganda.
BACKGROUND
First-episode secondary mania in human immunodeficiency virus (HIV) infection has been described among samples of predominantly Caucasian, HIV-positive male patients in developed countries.


OBJECTIVE
The goal of this study was to compare the demographic and clinical characteristics of HIV-positive patients with early-onset and late-onset first-episode secondary mania in HIV infection. There were previous findings of an association between late-onset mania and severe cognitive impairment.


METHODS
Subjects were HIV inpatients with clinically-confirmed mania, who received standard demographic, psychiatric, physical, and laboratory assessments. Early-onset patients had CD4 cell counts > 200 mm(3); late-onset patients had CD4 cell counts < or = 200 mm(3).


RESULTS
There were no demographic or cognitive differences between early-onset and late-onset mania patients, and high rates of psychotic symptoms in both groups. However, late-onset patients had more manic symptoms.


CONCLUSIONS
Late-onset HIV mania patients had more severe psychopathology and, thus, demonstrated a greater need for highly active retroviral therapy.
Nakimuli-Mpungu
Etheldreda
E
Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health, Baltimore, MD 21205, USA. ethelmpungu@yahoo.com
Musisi
Seggane
S
Kiwuwa Mpungu
Steven
S
Katabira
Elly
E
D015526:AIDS Dementia Complex / Q000453:epidemiology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult