Neuropsychiatric Complications of HIV Infection: Public Policy Implications

The human immunodeficiency virus (HIV) infects the central nervous system (CNS), causing symptoms in most persons with AIDS-related complex (ARC) and AIDS, and in a significant proportion of those classified as asymptomatic seropositive. The most common clinical syndrome secondary to CNS infection is known as HIV encephalopathy. When sufficiently disabling, HIV encephalopathy is known as AIDS dementia, and must be reported to the Centers for Disease Control as a case of AIDS. AIDS dementia is a complex of cognitive, affective, behavioral, and motor symptoms which varies widely in its presentation. In some persons, cognitive impairment predominates, manifesting in a loss of intellectual capacities such as short-term memory, information processing, and abstract thinking. When mood disturbance predominates, it may present as irritability, anxiety, depression, or mania. Behavioral complications are most often due to confusion or psychosis, and may render the patient difficult for caretakers to manage. Motor impairments include slowing, gait abnormalities, incontinence, and paralysis. AIDS dementia presents a significant challenge to the public health system. Physicians, other health providers, and policymakers must be educated so that they may tackle the problems of diagnosis, acute and chronic care, and public safety which are related to this illness

Characteristics of Freebase Cocaine Psychosis.

Psychosis was present in 29 percent of cocaine-disordered patients hospitalized in 1985 during an epidemic of freebase cocaine abuse in the Bahamas. Record reviews revealed that a variety of psychotic phenomenologic patterns were present. Prior major mental disorders and increased dosage of cocaine were more common among psychotic than non-psychotic patients. Violent behavior was common among cocaine patients, especially those with psychosis. We conclude that freebase cocaine psychosis is neither rare nor benign

Longitudinal consent-related abilities among research participants with schizophrenia: Results from the CATIE study

Research participants must have adequate consent-related abilities to provide informed consent at the time of study enrollment. We sought to determine if research participants with schizophrenia maintain adequate consent-related abilities during a longitudinal study. If participants lose abilities during a trial they may not be able to judge and protect their interests. If reduced abilities are common or can be predicted, special protections can be targeted appropriately

Altered language network activity in young people at familial high-risk for schizophrenia

Background—Abnormalities in language and language neural circuitry are observed in schizophrenia (SZ). Similar, but less pronounced language deficits are also seen in young first degree relatives of people with SZ, who are at higher familial risk (FHR) for the disorder than the general population. The neural underpinnings of these deficits in people with FHR are unclear. Methods—Participants were 43 people with FHR and 32 comparable controls. fMRI scans were collected while participants viewed associated and unrelated word pairs, and performed a lexical decision task. fMRI analyses conducted in SPM8 examined group differences in the modulation of hemodynamic activity by semantic association. Results—There were no group differences in demographics, IQ or behavioral semantic priming, but FHR participants had more schizotypal traits than controls. Controls exhibited the expected suppression of hemodynamic activity to associated versus unrelated word pairs. Compared to controls, FHR participants showed an opposite pattern of hemodynamic modulation to associated versus unrelated word pairs, in the left inferior frontal gyrus (IFG), right superior and middle temporal gyrus (STG) and the left cerebellum. Group differences in activation were significant, FWE-corrected for multiple comparisons (p<0.05). Activity within the IFG during the unrelated condition predicted schizotypal symptoms in FHR participants. Conclusions—FHR for SZ is associated with abnormally increased neural activity to semantic associates within an inferior frontal/temporal network. This might increase the risk of developing unusual ideas, perceptions and disorganized language that characterize schizotypal traits, potentially predicting which individuals are at greater risk to develop a psychotic disorder

Prevalence of Neurological Soft Signs and Their Neuropsychological Correlates in Typically Developing Chinese Children and Chinese Children With ADHD

This study examined prevalence of soft signs in 214 typically developing Chinese children and investigated whether soft signs are associated with attention deficit hyperactivity disorder (ADHD) in this population. Chinese children with ADHD (N = 54) scored significantly higher than age-matched controls on all three soft signs subscales and motor coordination correlated significantly with Stroop interference. Logistic regression supported the utility of the soft sign scales in discriminating children with ADHD and controls. Children with ADHD had a significant excess of soft signs, which may be a useful marker of developmental disruption in this clinical condition. 2010 10 30. Copyright © 2010 Taylor & Francis Group, LLC.link_to_subscribed_fulltex

Neurological soft signs in individuals with schizotypal personality features

Objective: The current study attempted to examine the prevalence of neurological soft signs and their relationships with schizotypal traits in individuals with psychometrically defined schizotypal personality disorder (SPD) features