Depression and Neurocognitive Performance in Portuguese Patients Infected with HIV
Depression and Neurocognitive Performance in Portuguese Patients Infected with HIV
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DOI：
10.1007/s10461-011-9973-3
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发表时间：
2011-11-01
影响因子：
4.4
通讯作者：
Palha, Antonio
中科院分区：
文献类型：
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作者：
Braganca, Miguel;Palha, Antonio
本研究关注与HIV感染相关的神经认知障碍，描述了最受影响的神经心理领域及其作为抑郁相关因素的潜力。130例HIV阳性者，CD 4> 200 cells/mm（3），病毒载量检测不到，接受HAART治疗，有各种危险行为。采用由七个部分组成的结构化访谈，并评估相关临床和实验室数据。对于神经心理学和抑郁评估，选择HIV神经行为研究中心（HNRC）成套测验和汉密尔顿抑郁量表（HAM-D）。进行单因素非参数统计和多元回归分析。在34%的抑郁症受试者中，20.7%曾试图自杀，45.4%正在接受精神药物治疗，只有19%没有艾滋病毒相关神经认知障碍（HAND）的诊断标准。抑郁症对认知功能的影响显示，在八项措施中有五项显着恶化。在多变量分析中，五个变量显着确定抑郁症：性别，社会阶层，抗抑郁药物，自杀企图和敏捷和运动速度（神经心理测试电池）的历史。尽管患者对治疗（HAART和抗抑郁药）的依从性良好，免疫状态良好，但HAND和抑郁症的患病率很高，表明抑郁症的严重程度与认知功能之间存在显著关系。
This study focused on neurocognitive disorders associated with HIV infection, characterizes the most affected neuropsychological domains and their potential as factors related with depression. 130 HIV-positive individuals with CD4 > 200 cells/mm(3), undetectable viral load, treated with HAART and with all kinds of risk behaviors were included. A structured interview composed by seven sections was used and relevant clinical and laboratory data was assessed. For the neuropsychological and depression assessment the HIV Neurobehavioral Research Center (HNRC) Battery and Hamilton Rating Scale for Depression (HAM-D) were chosen. Univariate nonparametric statistics and multivariate regression model were performed. Among 34% of depressed subjects, 20.7% had attempted suicide, 45.4% were under psychiatric medication and only 19% had no diagnostic criteria for HIV Associated Neurocognitive Disorders (HAND). The effect of depression on cognitive function revealed a significant deterioration in five of the eight measures. In the multivariate analysis, five variables significantly determined depression: sex, social class, antidepressant medication, history of suicide attempt and Dexterity and motor speed (neuropsychological test battery). Despite good patient adherence to treatment (HAART and antidepressive) and good immune status, the prevalence of HAND and depression are high and suggest a significant relation between severity of depression and cognitive functioning.