Atkins Jana H, Rubenstein Sarah L, Sota Teresa L, Rueda Sergio, Fenta Haile, Bacon Jean, Rourke Sean B
Neurobehavioural Research Unit, Mental Health Service, St. Michael's Hospital, Toronto, ON, Canada.
AIDS Care. 2010 Jul;22(7):793-802. doi: 10.1080/09540120903482994.
As many as 50% of people living with HIV/AIDS report cognitive difficulties, which can be associated with objective neuropsychological impairments and depression. A number of studies have demonstrated an association between higher social support and lower rates of depression. Using a cross-sectional design, we examined the role social support may play in attenuating the effects of both neuropsychological status and depression on cognitive difficulties. A total of 357 participants completed a battery of neuropsychological tests, questionnaires about cognitive difficulties and depression, and an interview that included an assessment of perceived level of social support. A multivariate linear regression analysis revealed that higher levels of cognitive symptom burden were significantly associated with depression (P<0.05) while lower levels of cognitive symptom burden were significantly associated with greater social support (P<0.01) and higher level of education (P<0.05). There was a significant interaction between neuropsychological status and depression (P<0.001); the presence of neuropsychological impairment with depression was associated with higher levels of cognitive symptom burden. There was also a significant interaction between social support and depression (P<0.05). Interestingly, social support was also associated with a lower cognitive symptom burden for non-depressed individuals living with HIV/AIDS. These findings have important clinical implications for promoting psychological well-being in persons living with HIV/AIDS. To improve quality of life, it is important to screen for and identify individuals with HIV/AIDS who may be depressed and to intervene appropriately. Further research should examine the potential role of social support interventions in modifying the effects of both depression and neuropsychological status on cognitive symptom burden.
高达50%的艾滋病毒/艾滋病感染者报告有认知困难，这可能与客观的神经心理损伤和抑郁有关。多项研究表明，较高的社会支持与较低的抑郁率之间存在关联。我们采用横断面设计，研究了社会支持在减轻神经心理状态和抑郁对认知困难的影响方面可能发挥的作用。共有357名参与者完成了一系列神经心理测试、关于认知困难和抑郁的问卷，以及一次包括对感知社会支持水平评估的访谈。多元线性回归分析显示，较高水平的认知症状负担与抑郁显著相关（P<0.05），而较低水平的认知症状负担与较高的社会支持（P<0.01）和较高的教育水平（P<0.05）显著相关。神经心理状态和抑郁之间存在显著的交互作用（P<0.001）；神经心理损伤伴抑郁与较高水平的认知症状负担相关。社会支持和抑郁之间也存在显著的交互作用（P<0.05）。有趣的是，社会支持也与艾滋病毒/艾滋病非抑郁感染者较低的认知症状负担相关。这些发现对促进艾滋病毒/艾滋病感染者的心理健康具有重要的临床意义。为了提高生活质量，筛查和识别可能抑郁的艾滋病毒/艾滋病感染者并进行适当干预很重要。进一步的研究应探讨社会支持干预在改变抑郁和神经心理状态对认知症状负担的影响方面的潜在作用。
