[Anxious-depressive state and cognitive deficit in HIV infection].
This study tries to demonstrate the importance of using follow-up trials and taking anxio-depressive status into account while interpreting cognitive impairment in HIV-infected subjects. Subjects included were: 18 HIV carriers, mostly homosexual, belonging to CDC groups II (4), III or IVC2 (7) and IV (7), selected within a cohort of 63, as having been assessed 3 times, with no focal or identified brain disease at entry. Our methods were: 1) psychiatric interview based on DSM III-R criteria, clinical scales (Spielberger's STAXI and the MADRS) and cognitive questionnaires; 2) neuropsychological evaluation including 16 subtests screening attention, memory, visuo-spatial function, motor dexterity, psychomotor speed, and language; 3) repeated assessment within a period ranging from 6 to 21 months.


RESULTS
At entry, cognitive status was impaired for 14 subjects (2 II, 5 III or IVC2, 7 IV). Disorders had disappeared for 7 subjects (2 II, 2 IVC2 and 3 IV) at following assessments allowing us to conclude on a psychogenic origin. For 7 subjects, cognitive status had either remained constant (3 III and 2 II) or had worsened within 7 to 17 months (2 IV), whereas psychiatric symptoms had decreased, implying HIV encephalopathy. Follow-up trials including 3 neuropsychological and psychiatric assessments and neuroimagery, if necessary, were required to ascertain the causes of cognitive impairment consequently attributed to anxio-depressive symptoms or HIV encephalopathy in 14 subjects.
Silvestre
D
D
U158 INSERM, Hôpital Necker-Enfants Malades, Paris.
Linard
F
F
Desi
M
M
Seibel
N
N
Korezlioglu
J
J
Pequart
C
C
Saimot
A G
AG
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000523:psychology*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010555:Personality Inventory; D012803:Sick Role
Statut anxio-dépressif et déficit cognitif au cours de l'infection par le VIH.