Clinical presentation of first episode psychosis in people with and without HIV in KwaZulu-Natal, South Africa.

Journal: Early intervention in psychiatry

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Affiliated Institutions:  Department of Psychiatry, College of Health Sciences, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract summary 

Mental disorders and HIV are the main contributors to the increase in years lived with disability rates per person in sub-Saharan Africa. A complex inter-relationship exists between HIV and mental illness, especially in a region with a high HIV prevalence. We examined the duration of untreated psychosis (DUP), and the nature of psychotic and cognitive symptoms in people with first episode psychosis (FEP) living with and without HIV.Adults aged between 18 and 45 years were assessed using a clinical interview, physical examination and several psychiatric tools. These included the Mini International Neuro-psychiatric Interview to confirm psychosis, Positive and Negative Syndrome Scale, International HIV Dementia Scale and other scales to measure symptom variables. HIV ELISA was used for HIV serology testing, with measures being carried out within 6 weeks of the first presentation.Of the 172 people presenting with FEP, 36 (21%) had comorbid HIV, those with both being older and more likely to be female (p < .001). Clinically, participants with FEP and HIV scored lower on the positive subscale (p = .008). There were no statistically significant differences for DUP or cognitive screening. Of those living with HIV and FEP (n = 36) comorbidity, nine were newly diagnosed with HIV at the time of the study.Individuals presenting with FEP and comorbid HIV were older, female and reported more mood symptoms. The identification of nine new HIV infections also reflects the ongoing need to test for HIV in people presenting with severe mental illness.

Authors & Co-authors:  Chhagan Usha U Ntlantsana Vuyokazi V Karim Enver E Thela Lindokuhle L Tomita Andrew A Chiliza Bonginkosi B Paruk Saeeda S

Study Outcome 

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Statistics
Citations :  Atkinson, J. H., Grant, I., Kennedy, C. J., Richman, D. D., Spector, S. A., & McCutchan, J. A. (1988). Prevalence of psychiatric disorders among men infected with human immunodeficiency virus: A controlled study. Archives of General Psychiatry, 45(9), 859–864.
Authors :  7
Identifiers
Doi : 10.1111/eip.13561
SSN : 1751-7893
Study Population
Male,Female
Mesh Terms
Other Terms
FEP;HIV;South Africa;mood symptoms;positive symptoms
Study Design
Study Approach
Country of Study
Publication Country
Australia