OBJECTIVE: The authors examined HIV-positive subjects to determine the
relationship of patient complaints of cognitive and motor dysfunction to
psychiatric status and performance on established cognitive and motor
function tests. METHOD: HIV-positive volunteers (N = 77) were evaluated at
entry into a longitudinal neurological study. Forty were asymptomatic, 29
had AIDS-related complex, and eight had AIDS. The subjects were not
selected for the presence or absence of cognitive or motor complaints.
Complaints of cognitive and motor dysfunction were assessed with items from
the AIDS Clinical Trials Group Macro Neurologic Exam. Current depression
and anxiety were assessed with the Profile of Mood States. Psychiatric
status was assessed with the NIMH Diagnostic Interview Schedule, a
structured interview that provides DSM- III psychiatric diagnoses. Actual
cognitive and motor performance was measured with standard
neuropsychological tests known to be sensitive to the effects of HIV.
RESULTS: Cognitive complaints were found in 38 (49%) of the subjects. These
complaints were associated with psychiatric symptoms but not with cognitive
performance. Motor complaints, found in 12 (16%) of the subjects, were
associated with poorer motor performance but not with psychiatric symptoms.
The overall frequency of psychiatric diagnosis was high. CONCLUSIONS:
Self-reports of cognitive and motor dysfunction were common in this
unselected group and are of concern to health care providers. Potentially
treatable psychiatric conditions were also common, particularly in subjects
with cognitive complaints, and appropriate treatment referrals are
indicated. Patients who report motor dysfunction should be neurologically
evaluated for treatable causes.