Case Series of Mania Secondary to HIV/AIDS in Patients at two Tertiary Hospitals in Lusaka, Zambia

Abstract

Objective: The objective of the study was to gain the greater knowledge of the mania secondary to HIV/AIDS while specific objectives were to determine whether the specific clinical characteristics of mania secondary to HIV identified in previous studies are also found in Zambian patients and to determine whether patients with secondary mania have increased irritability.

Design: A case series was carried out at Chainama Hills Hospital and University Teaching Hospital in which ten patients suffering from secondary mania due to HIV were recruited and followed during a period of 2 months. They were assessed for symptom severity, demographic and clinical characteristics of interest at the time of recruitment in the study and followed up at 4 weeks and 8 weeks. The patients were given routine care and treatment during their stay in the hospital, which included HAART, antipsychotics as well as mood stabilizers.

Results: Six out of ten patients were females and four were males. The minimum age of the participants was 19 years; the maximum age was 48 years while the average age was 35.3 years. The minimum CD4 count was 3; the maximum CD4 count was 319 while the average CD4 count was 156.00 (SD142.45); median was 152.50. CD4. The Young Mania Rating Scale scores were calculated at the time of recruitment and at the time of follow up at 4 weeks and at 8 weeks after discharge. The mean YMRS at the time of follow up (8weeks) was zero while YMRS at time of follow up (4 weeks) was 12.40(SD 6.85), which was significantly lower than mean YMRS at the time of recruitment 42.70 (SD 8.44), (t=5.724; df=9; p=0.001; <0.05). Furthermore, the mean Irritability Score on YMRS at time of follow up (8weeks) was zero while at the time of follow up (4weeks),it was 2.40(SD 2.06), which was significantly lower than mean Irritability Score on YMRS at the time of recruitment 5.20(SD 2.7), (t=3.674; df=9; p=0.005; <0.05).

Conclusion: The use of anti-psychotics, mood stabilizers and initiation of HAART in patients with mania due to HIV is effective in the management of these patients.