Millikin Colleen P, Rourke Sean B, Halman Mark H, Power Christopher
Mental Health Service and Inner City Health Research Unit, St Michael's Hospital, Toronto, Ont, Canada.
J Clin Exp Neuropsychol. 2003 Apr;25(2):201-15. doi: 10.1076/jcen.25.2.201.13644.
Fatigue and depressive symptoms are common in HIV-infection. The relationship between these symptoms and neuropsychological functioning is poorly understood, particularly in symptomatic infection/AIDS. This study examined the associations among fatigue, depressive symptoms, subjective neurocognitive complaints, and objective neuropsychological performance in HIV/AIDS. Sixty-eight men with HIV-infection (27 adults with HIV-infection but not AIDS and 41 with AIDS diagnosis) completed a neuropsychological test battery and self-report measures of fatigue (Fatigue Severity Scale), depressive symptoms (Beck Depression Inventory), and subjective neurocognitive complaints (Patient's Assessment of Own Functioning). High levels of fatigue were endorsed by participants. Fatigue severity was related to depressive symptoms but not to AIDS diagnosis or medication status. Verbal learning and motor function was worse in participants with AIDS, but neuropsychological functioning was not significantly correlated with fatigue or depressive symptoms. Subjective neurocognitive complaints were predicted by both depressive symptoms and fatigue. Our results suggest that adults with fatigue and HIV-infection (with or without AIDS) should be screened for depression. Neither fatigue nor depressive symptoms appear to affect neuropsychological functioning in HIV/AIDS. Future research is needed to develop and evaluate instruments and methods to differentiate depression-related fatigue from fatigue that may reflect underlying medical disease. Such research will further the development of effective treatments for fatigue associated with HIV-infection.
疲劳和抑郁症状在HIV感染中很常见。这些症状与神经心理功能之间的关系尚不清楚,尤其是在有症状感染/艾滋病患者中。本研究调查了HIV/AIDS患者中疲劳、抑郁症状、主观神经认知主诉和客观神经心理表现之间的关联。68名HIV感染者(27名HIV感染但未患艾滋病的成年人和41名已确诊艾滋病的患者)完成了一套神经心理测试以及关于疲劳(疲劳严重程度量表)、抑郁症状(贝克抑郁量表)和主观神经认知主诉(患者自身功能评估)的自我报告测量。参与者认可自己存在高水平的疲劳。疲劳严重程度与抑郁症状相关,但与艾滋病诊断或用药情况无关。艾滋病患者的言语学习和运动功能较差,但神经心理功能与疲劳或抑郁症状无显著相关性。抑郁症状和疲劳均可预测主观神经认知主诉。我们的结果表明,应对伴有疲劳的HIV感染者(无论是否患有艾滋病)进行抑郁症筛查。在HIV/AIDS中,疲劳和抑郁症状似乎均不影响神经心理功能。未来需要开展研究来开发和评估区分与抑郁症相关的疲劳和可能反映潜在疾病的疲劳的工具和方法。此类研究将推动针对与HIV感染相关疲劳的有效治疗方法的发展。