A review of sexually transmitted diseases for the psychiatric practitioner

Abstract

Sexually transmitted diseases (STDs), including gonorrhea, chlamydia, syphilis, trichomoniasis, and bacterial vaginosis are a significant concern in patients with mental illnesses. In 1993, the Centers for Disease Control and Prevention (CDC) published recommendations for the treatment of STDs. Patients with gonococcal infections should be treated with a single-dose of ceftriaxone. In addition, patients with gonorrhea should be treated with a single dose of azithromycin for suspected chlamydial infections. In each of the four stages of syphilis, the CDC recommends treatment with penicillin, with differences in the frequency and duration of the regimen. In patients who are positive for infection with Trichomonas vaginalis, the CDC recommends a single dose of metronidazole. Patients with bacterial vaginosis should also be treated with metronidazole, but for a period of 7 days. Because some patients with mental illness may not have adequate access to regular medical care, the psychiatric clinician needs to have knowledge of diagnosis and treatment of the more common STDs that are likely to infect their patients.