title: Association between self-report of cognitive impairment, HIV status, and cocaine use in a sample of cocaine-dependent methadone-maintained patients.
abstract: HIV-disease as well as chronic cocaine abuse may both produce neuropsychological deficits that could potentially interfere with psychoeducational treatments for drug abuse. In this study, the Neuropsychological Impairment Scale (NIS), a 95-item self-report assessment instrument, was administered to 120 cocaine-dependent methadone-maintained patients (59 HIV-seropositive; 61 seronegative) to assess self-awareness of cognitive deficits in this patient population. HIV-seropositive cocaine users reported significantly more impairment than did HIV-seronegative cocaine users on all summary scores and six of seven clinical subscales. Controlling for the influence of sociodemographic variables (age, sex, ethnicity, and education), acute and chronic cocaine use, and effective distress, there was still a significant relationship between HIV status and self-report of neuropsychological impairment. Relative to patients with known neuropsychological deficits, 41% of HIV-seropositive cocaine users and 31% of HIV-seronegative cocaine users scored in the impaired range on the Global Impairment Index. Implications for treatment are discussed.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Avants
authors.forename: A
authors.initials: A
authors.lastname: Margolin
authors.forename: T J
authors.initials: TJ
authors.lastname: McMahon
authors.forename: T R
authors.initials: TR
authors.lastname: Kosten
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000150:complications*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009483:Neuropsychological Tests / Q000592:standards*; D009293:Opioid-Related Disorders / Q000150:complications / Q000534:rehabilitation; D012016:Reference Values; D012044:Regression Analysis; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D014504:Urban Health
chemical_list: D008691:Methadone