Unreliability of Current Screening Tests for Syphilis in Chronic Psychiatric Patients

Reeves, Roy R. DO, PhD
Pinkofsky, Harold B. MD, PhD
Kennedy, Kathryn K. MD

Received Dec. 12, 1995; revision received May 29, 1996; accepted June 24, 1996. From the Department of Psychiatry, Louisiana State University School of Medicine in Shreveport. Address reprint requests to Dr. Reeves, Department of Psychiatry, LSU School of Medicine, 1501 Kings Highway, Shreveport, LA 71130-3932.

American Journal of Psychiatry 153(11):p 1487-1488, November 1996.

Objective

This study examined whether psychiatrists perform adequate diagnostic screening for syphilis in patients with chronic mental illness. Method: Two hundred patients with chronic mental illness underwent testing for syphilis with the commonly used RPR test and the microhemagglutination assay for Treponema pallidum (MHA-TP). Sensitivities of the two tests were compared. Results: A substantial number of patients with negative results on RPR tests had reactive MHA-TPs and would have not been identified as having had syphilis with the use of RPR testing alone. Conclusions: Nontreponemal tests such as the RPR test are less likely than treponemal tests to detect syphilis appropriately in chronically mentally ill patients, and specific treponemal tests such as the MHA-TP should be considered.

(Am J Psychiatry 1996; 153:1487-1488)