Psychiatric aspects of AIDS

Acquired immune deficiency syndrome (AIDS) has neuropsychiatric and psychopathological complications: anxiety, depressive symptoms, and suicidal ideation are common. Patients may express anger toward ineffective medical care and perceived public discrimination, guilt about sexual practices or drug abuse, reactions to social isolation, and uncertainty about the implications of an AIDS diagnosis. CNS dysfunction and subsequent neuropsychiatric impairment are common and are initially characterized by decreased acuity, slowed mentation, and psychomotor retardation that can resemble depression. Marked global cognitive deficits, disorientation, and delusions ensue. The author discusses case management and outlines future clinical and research activities.