Heaton R K, Velin R A, McCutchan J A, Gulevich S J, Atkinson J H, Wallace M R, Godfrey H P, Kirson D A, Grant I
University of California, San Diego, School of Medicine.
Psychosom Med. 1994 Jan-Feb;56(1):8-17. doi: 10.1097/00006842-199401000-00001.
Individuals infected with the human immunodeficiency virus-Type 1 (HIV-1), are at increased risk for neurobehavioral impairment, particularly in later stages of the disease. Even patients in the medically asymptomatic or minimally symptomatic stages of infection may show mild deficits on comprehensive neuropsychological (NP) test batteries, although the clinical significance of such deficits remains uncertain. The present study used vocational difficulties as markers of clinical significance of NP impairment. In a sample of 289 HIV-infected, nondemented men, those who evidenced NP impairment had a higher unemployment rate (p < .001) than did their unimpaired counterparts. In HIV-positive subjects who remained employed, NP impairment was strongly associated with subjective decreases in job-related abilities. Neither depression nor medical symptoms could explain the relationship between the NP impairment and employment problems. These results are consistent with previous studies investigating other neuropsychiatric disorders, which suggest that even mild NP impairment can interfere with employment status. From this standpoint, such impairment in HIV-infected persons may be described as "clinically significant."
感染人类免疫缺陷病毒1型（HIV-1）的个体出现神经行为损害的风险增加，尤其是在疾病后期。即使是处于医学无症状或症状轻微阶段的感染患者，在全面的神经心理学（NP）测试组中也可能表现出轻度缺陷，尽管这些缺陷的临床意义仍不确定。本研究将职业困难作为NP损害临床意义的指标。在289名感染HIV的非痴呆男性样本中，有NP损害的人失业率（p < .001）高于未受损的同龄人。在仍在工作的HIV阳性受试者中，NP损害与工作相关能力的主观下降密切相关。抑郁和医学症状均无法解释NP损害与就业问题之间的关系。这些结果与之前调查其他神经精神疾病的研究一致，这些研究表明，即使是轻度的NP损害也会干扰就业状况。从这个角度来看，HIV感染者的这种损害可被描述为“具有临床意义”。
