Cysique Lucette A, Deutsch Reena, Atkinson J Hampton, Young Corinna, Marcotte Thomas D, Dawson Lauren, Grant Igor, Heaton Robert K
Department of Psychiatry, University of California at San Diego, San Diego, California, USA.
J Int Neuropsychol Soc. 2007 Jan;13(1):1-11. doi: 10.1017/S1355617707070026.
The diagnosis of lifetime major depressive disorders (MDDs) and of current major depressive episodes (MDEs) are relatively common in HIV-infected individuals, and often are assumed to influence neuropsychological (NP) performance. Although cross-sectional studies of HIV-infected individuals generally have found no systematic link between current MDE or depressive symptoms and NP performance, longitudinal studies are needed to clarify whether incident MDE may impact NP functioning in at least some cases. Two hundred twenty-seven human immunodeficiency virus (HIV)-infected adult men, who did not meet criteria for a current MDE at baseline, participated in a longitudinal NP study for an average of two years. Participants received repeated NP assessments, as well as structured psychiatric interviews to ascertain presence or absence of both lifetime MDD and current MDE. Ninety-eight participants had a lifetime history of MDD, and 23 participants met criteria for incident MDE at one of their follow-up evaluations. Groups with and without lifetime MDD and/or incident MDE had comparable demographics, HIV disease status and treatment histories at baseline, and numbers of intervening assessments between baseline and the final follow-up. Lifetime MDD was associated with greater complaints of cognitive difficulties in everyday life, and such complaints were increased at the times of incident MDE. However, detailed group comparisons revealed no NP performance differences in association with either lifetime or incident major depression. Finally, NP data from consistently nondepressed participants were used to develop "norms for change" and these findings failed to show any increased rates of NP worsening among individuals with incident MDE. Our results suggest that neurocognitive impairment and major depression should be considered as two independent processes.
终生重度抑郁症（MDD）和当前重度抑郁发作（MDE）的诊断在HIV感染者中相对常见，并且通常被认为会影响神经心理学（NP）表现。尽管对HIV感染者的横断面研究通常未发现当前MDE或抑郁症状与NP表现之间存在系统性关联，但仍需要纵向研究来阐明偶发性MDE是否至少在某些情况下会影响NP功能。227名感染人类免疫缺陷病毒（HIV）的成年男性在基线时不符合当前MDE的标准，他们参与了一项平均为期两年的纵向NP研究。参与者接受了重复的NP评估，以及结构化的精神病学访谈，以确定是否存在终生MDD和当前MDE。98名参与者有MDD的终生病史，23名参与者在一次随访评估中符合偶发性MDE的标准。有和没有终生MDD和/或偶发性MDE的组在基线时的人口统计学、HIV疾病状态和治疗史相当，并且在基线和最终随访之间的干预评估次数也相当。终生MDD与日常生活中更多的认知困难主诉相关，并且在偶发性MDE发作时此类主诉会增加。然而，详细的组间比较显示，与终生或偶发性重度抑郁症相关的NP表现没有差异。最后，来自始终未患抑郁症的参与者的NP数据被用于制定“变化规范 ”，这些结果未能显示偶发性MDE患者中NP恶化率有任何增加。我们的结果表明，神经认知障碍和重度抑郁症应被视为两个独立的过程。
