HIV, AIDS og psykose: Et klinisk eksempel

Abstract

A 24-year-old woman with AIDS developed a psychotic state characterized by a delusional complex relating to HIV infection and other major life events. The psychotic thought content could be interpreted as a “purposeful” result of denial and projection. Jasper's criteria for a genuine psychogenic reaction were fulfilled. Additionally, there were indications of an organic component in the psychosis: euphoric state, uncritical and megalomanic aspects, periodic psychomotor agitation, clinical signs of intellectual impairment, and perseveration. The presence of an organic component was substantiated by the presence of neurologic signs of CNS infection (grand mal seizure, transient blurring of vision, slight cortical atrophia on CT). The patient had not previously been psychotic; she had a clear consciousness and was not hallucinating. The criteria for an organic HIV psychosis are parallel to the previously well-known signs of neurolues. HIV infection is a condition in which a combined organic-psychogenic etiology of psychosis should be suspected. In conclusion, psychotic states in HIV-infected patients are developed by well-known pathogenetic mechanisms, and such cases should be included and treated as part of general psychiatry.

Key Words:

• AIDS
• HIV
• Organic psychosis
• Psychogenic psychosis
• Syphilis