Manic syndrome in AIDS

Article Abstract:

AIDS patients often suffer from cognitive impairment and nervous system disorders related to infection with the human immunodeficiency virus (HIV), which causes AIDS. Manic syndrome has been reported by some studies to be a symptom in some AIDS patients, although few data showing an association between neurological disease and mania were reported in these studies. This study examined the relationship between manic syndrome in AIDS patients and the underlying HIV infection. All patients with AIDS were inpatients in a hospital psychiatric department from August 1, 1986 through the April 1, 1990. Eight patients met the criteria for a manic syndrome, and underwent clinical, laboratory, and imaging examinations. Magnetic resonance images of the brain were obtained and lumbar punctures were performed to obtain spinal fluid samples from the patients. Upon admission, manic syndrome symptoms of irritability were seen in six patients and grandiosity in four patients. Lithium was given to four patients and neuroleptics to six patients to treat the mania. Cognitive testing performed after the symptoms of mania abated showed abnormalities consistent with HIV-related impairment, including memory deficits in four patients and impaired cognitive flexibility in three patients. Examination of cerebral spinal fluid showed only minor abnormalities in four patients. Results of MRI were abnormal for all eight patients. In seven patients, abnormalities in the regions of the fornix and corpus callosum of the brain were seen. Brain atrophy was observed in two patients and changes in white matter occurred in four patients. Based on the average lifetime risk of developing a manic episode, a significantly greater number than expected were observed in the AIDS patients. These results indicate that manic syndrome may be a secondary disorder of HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Causes of, Complications and side effects, HIV infection, HIV infections, AIDS (Disease), Mania

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Magnetic resonance spectroscopy in psychiatry: potential, pitfalls, and promise

Article Abstract:

Magnetic resonance spectroscopy (MRS) is increasingly being used in research examining brain physiology in psychiatric disorders. MRS is a noninvasive procedure that can measure the levels of isotopes of a number of elements within the brain. These isotopes resonate when an external magnetic field is applied; the frequency varies for each element and a slight variation is observed for the same element within different chemical compounds. By MRS measurement of these frequencies, the amounts of certain chemical compounds in the brain and the changes in the amounts of these compounds can be derived. MRS is often used to measure the levels of phosphorous-containing compounds. Many of these compounds are involved in energy metabolism or are integral components of cell membranes. Research on Alzheimer's disease has shown that the levels of various phospholipids, important components of cell membranes, in Alzheimer's patients are different from levels in subjects without this disease. MRS studies of patients with dementia caused by several areas of tissue destruction have shown alterations in the ratios of phosphorous-containing compounds that are involved in energy metabolism, indicating impairment of energy metabolism in these patients. Isotopes of fluorine can also be measured by MRS. Fluorine compounds are present in only small amounts in the brain, and can therefore be used for tracer studies. In tracer studies, a drug, or other substance such as glucose, is labeled with fluorine before it is given to the patient. MRS can then follow the metabolism of the labeled compound, and may also be used to measure the amount of compounds containing carbon, hydrogen, sodium, and lithium. Psychiatric research using MRS is just beginning, but promises to provide valuable information about brain physiology in psychiatric disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Brain, Nuclear magnetic resonance

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Somatization and psychiatric disorder in the NIMH Epidemiologic Catchment Area study

Article Abstract:

Somatizing patients are those who frequently complain of physical problems that have no apparent physiological cause. Patients who experience frequent somatic symptoms are thought to have a higher prevalence of psychiatric disorders than the general population. It is not clear if these patients are unwilling or unable to report psychological problems and therefore translate them into physical symptoms. To address this question and the question of whether somatization is associated with specific psychiatric disorders, data from the National Institute of Mental Health Epidemiologic Catchment Area study were reviewed. Results showed that 63 percent of persons reporting five or more somatic symptoms also had psychological symptoms, compared with 7 percent of the persons reporting no somatic symptoms. The results did not show an avoidance of reporting emotional symptoms by those reporting somatic symptoms. When specific psychiatric disorders were compared with somatic symptoms, somatization was strongly associated with depression and anxiety disorders and moderately associated with schizophrenia and mania. The results indicated that somatic symptoms are more likely an expression of psychological distress rather than an attempt to defend against awareness of psychological problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Somatoform disorders, Depression, Mental, Depression (Mood disorder)

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