Psychiatric problems of AIDS inpatients at the New York Hospital: preliminary report.

A retrospective review of the charts of 52 patients with acquired immune deficiency syndrome (AIDS) in the New York Hospital was conducted to determine the prevalence of recorded psychiatric complications and the use of psychiatric consultation. Neuropsychiatric complications were found to be pervasive clinical features in AIDS patients hospitalized during acute illness. Mood disturbance was identified in an overwhelming majority of the patients (82.7 percent), and signs of organic mental syndrome (DSM III) were noted in 65.4 percent; references to neuropsychiatric complications appeared in every patient's chart. Neurological complications were seldom explicitly diagnosed or treated. Psychiatric consultation was requested for 10 patients (19.2 percent) because of management problems, for diagnostic assessment, or by self-referral. Only one patient was given a psychiatric diagnosis at discharge. The results suggest that the neuropsychiatric complications of AIDS are underdiagnosed during acute medical illness and that psychiatric consultation is underutilized. AIDS patients have a heightened risk of psychological problems. Contributing factors may include the threat to life, severe physical debilitation, central nervous system involvement, fear of contagion, disclosure of homosexuality or drug abuse, and guilt associated with sexual transmission.