TITLE:
Psychiatric Aspects of Infectious Diseases
AUTHORS:
Amir Mufaddel, Abdelaziz A. Omer, Mohamed Omar Salem
KEYWORDS:
Bacterial Infections, Viral Infections, Parasitic Infections, Psychiatric Symptoms, Neuropsychiatric Features
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.3,
July
9,
2014
ABSTRACT: Psychiatric symptoms can be associated
with several systemic and central nervous system infections and they can be the
initial presenting symptoms, occurring in the absence of neurological symptoms in
some disorders as in some cases of viral encephalitis. They could also be part of
the clinical picture in other cases such as psychosis or mood symptoms secondary
to brucellosis or toxoplasmosis. Late-onset neuropsychiatric complications may also
occur several years following the infection such as in the case of subacute sclerosing
panencephalitis due to measles. Some Infectious diseases may have possible etiological
role for major psychiatric disorders, based on yet unconfirmed reports for viral
infectious diseases (e.g. Influenza virus and HSV-1) which are thought to have risk
for developing schizophrenia and psychosis. Neuropsychiatric adverse effects can
occur due to drugs (e.g. mefloquine, interferon-alpha) that are used for treatment
of infectious diseases. Psychiatric symptoms can also be reactivated resulting from
chronic, complicated and serious infections such as HIV that can lead to depression,
anxiety or adjustment disorders, although CNS involvement can also be a possible
etiological factor. Patients suffering from primary and severe psychiatric disorders
are at increased risk of contracting infection; that is mainly related to high risk
behaviors in patients with mania or schizophrenia. It is also important to consider
that the co-occurrence of psychiatric symptoms and infection can be incidental (i.e. infectious diseases can occur in psychiatric
patients regardless of the above mentioned factors). Early identification of the
underlying etiology for organic/secondary psychiatric symptoms is essential for
appropriate intervention and early treatment of the primary condition that could
be the etiology of psychiatric symptoms so as to avoid unnecessary long-term psychiatric
treatment and to avoid complications of possible misdiagnosis or delayed diagnosis
of the primary condition.