Unreliability of current screening tests for syphilis in chronic psychiatric patients.

Abstract

This study examined whether psychiatrists perform adequate diagnostic screening for syphilis in patients with chronic mental illness. 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. 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. 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.