Psychiatric issues and human immunodeficiency virus-associated dementia

Neurological and psychiatric morbidity are commonly associated with advanced HIV infection. Dementia, delirium, major depression, and mania usually are confined to the symptomatic stages of HIV infection. Cognition, behavior, and motor function abnormalities all are associated with HIV dementia. HIV dementia and major depression may occur together or as separate conditions in AIDS patients. Neuropsychological testing is useful in distinguishing demential for depression. The diagnostic work-up for HIV dementia includes a detailed history and physical examination, neuropsychological testing, laboratory studies including cerebrospinal fluid analysis, and neuroimaging. Effective treatment is available for some patients with HIV dementia, depression, and mania.