A chart review of human immunodeficiency virus status in patients admitted with psychosis in Durban, South Africa

Abstract

Background: Comorbid human immunodeficiency virus (HIV) infection among patients with psychotic disorders is associated with a poorer outcome. Understanding the association of HIV infection with demographic and clinical variables may provide clues to modify risk factors and outcomes.

Aim: To describe and compare the socio-demographic and clinical profile of patients admitted with psychotic disorders with and without HIV infection.

Method: A retrospective chart review of 100 adult patients consecutively admitted with psychosis and HIV infection and compared to 101 patients with psychosis without HIV infection.

Results: HIV-infected patients with psychotic disorders were more likely to be females (74.0%), younger than 50 years (94.0%) and less likely to have secondary education than HIV- negative patients with psychotic disorders (56.0% vs. 72.0%). HIV-infected patients were also less likely to be diagnosed as having schizophrenia (33.0%), had higher rates of medical (73.0%) and psychiatric (21.0%) comorbid disorders and were less likely to report lifetime nicotine and cannabis use (p = 0.047 and p = 0.011). HIV-negative patients with psychotic disorders were more likely to be readmitted to the unit in the next 12 months (p < 0.05). HIV-infected patients with psychotic disorders had increased abnormal haematological results (33.0%).

Conclusion: Patients with psychotic disorders and HIV infection had several negative prognostic factors such as younger age, increased rates of medical and psychiatric comorbidity, abnormal haematological results and longer length of admission periods. This suggests the need to target HIV prevention programmes at young females with mental illness and provide an integrated healthcare service with medical and psychiatric assessment and care for patients with HIV and psychosis.