Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, USA.
J Clin Exp Neuropsychol. 2012;34(7):773-81. doi: 10.1080/13803395.2012.682974. Epub 2012 May 10.
Episodic memory deficits are common in HIV infection and bipolar disorder, but patient insight into such deficits remains unclear. Thirty-four HIV-infected individuals without bipolar disorder (HIV+/BD-) and 47 HIV+ individuals with comorbid bipolar disorder (HIV+/BD+) were administered the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised to examine objective learning/memory functioning. Subjective memory complaints were assessed via the memory subscale of the Patient's Assessment of Own Functioning Inventory. HIV+/BD+ individuals performed poorer on tests of visual learning and visual/verbal recall than did HIV+/BD- participants (ps < .05). Memory complaints only predicted verbal learning (at a trend level, p = .10) and recall (p = .03) among the HIV+/BD- individuals. Memory complaints were not associated with memory performance within the HIV+/BD+ group (ps > .10). Memory complaints were associated with depressive symptoms in both groups (ps < 0.05). These complaints were also predictive of immunosuppression, higher unemployment, and greater dependence on activities of daily living among the HIV+/BD+ individuals (ps < .05). Awareness of memory abilities was particularly poor among HIV+/BD+ individuals (i.e., objective learning/memory did not correspond to reported complaints), which has important implications for the capacity of these individuals to engage in error-monitoring and compensatory strategies in daily life. Memory complaints are associated with depressed mood regardless of group membership. Among HIV+/BD+ individuals, these complaints may also signify worse HIV disease status and problems with everyday functioning. Clinicians and researchers should be cognizant of what these complaints indicate in order to lead treatment most effectively; use of objective neurocognitive assessments may still be warranted when working with these populations.
episodic 记忆缺陷在 hiv 感染和双相情感障碍中很常见,但患者对这些缺陷的认识仍不清楚。34 名无双相情感障碍的 hiv 感染个体( hiv+/bd-)和 47 名合并双相情感障碍的 hiv 感染个体( hiv+/bd+)接受了霍普金斯词语学习测试修订版和简要视觉空间记忆测试修订版,以检查客观学习/记忆功能。通过患者自身功能评估量表的记忆分量表评估主观记忆抱怨。 hiv+/bd+个体在视觉学习和视觉/言语回忆测试中的表现逊于 hiv+/bd-参与者(p<.05)。记忆抱怨仅预测 hiv+/bd-个体的词语学习(趋势水平,p=0.10)和回忆(p=0.03)。记忆抱怨与 hiv+/bd+组内的记忆表现无关(p>.10)。在两组中,记忆抱怨都与抑郁症状相关(p<0.05)。这些抱怨也预测了 hiv+/bd+个体的免疫抑制、更高的失业和对日常生活活动的更大依赖(p<0.05)。 hiv+/bd+个体对记忆能力的认识特别差(即,客观学习/记忆与报告的抱怨不一致),这对这些个体在日常生活中进行错误监测和补偿策略的能力有重要影响。记忆抱怨与情绪低落有关,无论组内成员如何。在 hiv+/bd+个体中,这些抱怨也可能表示更严重的 hiv 疾病状况和日常功能问题。临床医生和研究人员应该意识到这些抱怨意味着什么,以便最有效地进行治疗;在与这些人群合作时,可能仍然需要使用客观的神经认知评估。