A lack of justification for routine screening assays for syphilis in general hospital psychiatric patients

Abstract

Of 136,035 Yale-New Haven Hospital patients who had screening tests for syphilis, 1.2% were VDRL (Venereal Disease Research Laboratory) positive, and 0.6% were FTA-Abs (Fluorescent Treponemal Antibody Absorption) positive. Of this total sample, 2037 were psychiatric inpatients, 15 of whom were VDRL positive (0.7%), and only 4 (0.2%) were FTA-Abs positive. The authors discuss the merits of routine screening based on this and other surveys. The results of screening the psychiatric subsample were of particular interest since these patients might be at risk for misdiagnosis and brain dysfunction. Of this psychiatric inpatient cohort: (1) the number of syphilitics identified was 3.8-fold lower than that in the total sample, (2) strong consideration could be given to screening only those DSM-III ( Diagnostic and Statistical Manual of Mental Disorders [ed 3]) diagnostic subgroups at risk, and (3) these were major affective disorders or delusional dementia. Further studies of other samples, psychiatric and nonpsychiatric, to define subgroups at risk are suggested.