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Clinical Presentation of Bipolar Mania in HIV-Positive Patients in Uganda

Received January 3, 2007; revised July 30, 2007; accepted August 21, 2007. From the Department of Psychiatry, Makerere University; Clinical Epidemiology Unit, Department of Medicine, Makerere University; and the Department of Medicine, Faculty of Medicine, Makerere University. Send correspondence and reprint requests to Dr. Etheldreda Nakimuli-Mpungu, MBChB, MMED (Psych), Department of Psychiatry, Makerere University, P.O. Box 7072, Kampala, Uganda. e-mail: ethelmpungu{at}yahoo.com
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Secondary mania in HIV-positive individuals has been well documented; however, cases of bipolar mania in HIV infection occur, as well. OBJECTIVE: This is the first controlled study of the demographic and clinical characteristics of bipolar mania and secondary mania in persons with HIV/AIDS in Uganda and Africa. METHOD: Patients were consecutively recruited from the adult psychiatric wards of Makerere University (Uganda) teaching hospitals. Diagnosis of acute manic episode was based on DSM–IV criteria. RESULTS: The HIV-positive patients with bipolar mania had more immune suppression and more cognitive impairment, suggesting that these patients may already have been cognitively and functionally impaired by their mental illness by the time they acquired HIV infection. DISCUSSION: These findings may be used to help clinicians and policymakers recognize and design appropriate interventions for this vulnerable group of patients. Further studies to delineate the phenomenology of mania in patients with HIV infection/AIDS are warranted.

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