Castellon Steven A, Hardy David J, Hinkin Charles H, Satz Paul, Stenquist Phillip K, van Gorp Wilfred G, Myers Hector F, Moore Larry
Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
J Clin Exp Neuropsychol. 2006 Apr;28(3):420-37. doi: 10.1080/13803390590935444.
Both depression and neurocognitive compromise are commonly observed among persons infected with the Human Immunodeficiency Virus (HIV). To date, the majority of studies have failed to find a consistent relationship between mood and cognition among HIV-seropositive (HIV+) individuals, suggesting that these constructs are independent of one another. However, depression is a multi-dimensional syndrome and its measurement often utilizes multi-factorial instruments containing cognitive, affective, somatic, and motivational components. The degree to which various symptoms or dimensions of depression might be related to neuropsychological performance in HIV-1 infection is not typically explored and was a main objective of the current study. A sample of 247 HIV+ persons completed both a comprehensive neurocognitive battery and the Beck Depression Inventory (BDI) as part of a standard clinical evaluation at a major community hospital. To examine the dimensionality of the BDI, a principal components analysis was conducted which suggested a three-factor solution comprised of factors representing Self-Reproach (SR), Mood-Motivation Disturbance (MM), and Somatic Disturbance (SOM). The relationship between each of these three factors and neurocognitive performance was examined using both regression and analysis of variance techniques. These analyses showed the MM factor, more so than either the SR or SOM factors, to be associated with several aspects of neurocognitive performance, including verbal memory, executive functioning, and motor speed. These findings suggest that certain items on depression rating scales may be more indicative of central nervous system (CNS) involvement than others. The association between disturbance in mood and motivation and neurocognitive compromise may suggest that each are sequelae of disease specific mechanisms.
抑郁症和神经认知功能损害在感染人类免疫缺陷病毒（HIV）的人群中都很常见。迄今为止，大多数研究未能在HIV血清阳性（HIV+）个体中找到情绪与认知之间的一致关系，这表明这些概念是相互独立的。然而，抑郁症是一种多维度综合征，其测量通常使用包含认知、情感、躯体和动机成分的多因素工具。抑郁症的各种症状或维度与HIV-1感染中的神经心理表现可能相关的程度通常未被探讨，这是本研究的主要目的。作为一家大型社区医院标准临床评估的一部分，247名HIV+患者的样本完成了一套全面的神经认知测试和贝克抑郁量表（BDI）。为了检验BDI的维度，进行了主成分分析，结果表明存在一个三因素解决方案，包括代表自责（SR）、情绪-动机障碍（MM）和躯体障碍（SOM）的因素。使用回归和方差分析技术检验了这三个因素与神经认知表现之间的关系。这些分析表明，MM因素比SR或SOM因素更与神经认知表现的几个方面相关，包括言语记忆、执行功能和运动速度。这些发现表明，抑郁评定量表上的某些项目可能比其他项目更能表明中枢神经系统（CNS）受累情况。情绪和动机障碍与神经认知损害之间的关联可能表明，它们都是疾病特定机制的后遗症。
