Filippova E. Cognitive and mood disorders in patients with opioid dependence and HIV-infection (diagnostic, clinic, treatment).

The dissertation basing on the results of study 204 persons.The first (basic) group consisted of 50 HIV-infected (HIV (+)) patients with opioid dependence (36 men and 14 women). The second group consisted of 53 HIV-negative (HIV (-)) persons with opioid dependence (41 men and 12 women). The third group included 51 HIV (+) patients without drug addiction(21 men and 30 women). The fourth group - the control -50 healthy persons (33 males and 17 females). Cognitive impairment was identified in 98.0% of patients first, 81.1% of the second and 86,3% of the third groups of patients. Dementia was diagnosed in 2.0% of patients first and third groups, mild cognitive impairment - 64.0% in the first and 72.5% of third groups , in other cases diagnosed with asymptomatic disorders. Revealed that the progression of HIV infection suffer the higher mental functions, which in ontogeny and phylogeny formed the most late. As demonstrated by study, depressive disorders of mild (total score on a scale MADRS 16-25) were found in 32.0% of patients first, 30.2% second, and 27.5% of the third group, the violation of moderate severity - in 2, 0% of patients first and 5.9% - the third group, severe depressive disorders (total score> 30) - 3.9% of patients in the third group. Depressive disorders in 17.6% patients of the third group had links with psychotrauma. Affective disorders were observed in 45.1% of HIV-infected persons without drug addiction. Hypomanic disorder (total score on a scale of YMRS 12-21) were found in 1.9% of patients in the second group and 7.8% - the third. Thus, comorbid disease (opioid dependence, HIV +) and the two diseases separately (opioid dependence and HIV infection) leads to a significant deterioration in the quality of life of patients. Found that the comorbid condition (opioid dependence and HIV infection) potentiate each other's adverse effects on cognitive function of patients. The examined patients showed a significant worsening of affective status, associated with an increase in cognitive deficits. It is shown that the use of substitution maintenance therapy significantly improves the cognitive and affective status of patients and their quality of life. Confirmed the effectiveness of substitution maintenance therapy in HIV-positive patients with opioid dependence in terms of increased commitment to anti-retroviral treatment.