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The Relationship Between Stressful Life Events and Cognitive Function in HIV-Infected Men

Received September 13, 2001; revised June 24, 2002; accepted September 16, 2002. From the Department of Psychiatry, Ohio State University College of Medicine and Public Health, Columbus, Ohio. Address correspondence to Dr. Robert A. Bornstein, Neuro Sciences Facility 1670 Upham Drive, Suite 130, Columbus, Ohio 43210-1252; bornstein.1{at}osu.edu (E-mail).

Previous studies have demonstrated an impact of stress on immune function, and recent studies have suggested an adverse effect of stress on the brain. However, no previous study has examined the impact of stress on cognitive function. This article examines the relationship between stress and cognitive function in 82 HIV-negative subjects and 251 HIV-positive subjects. Subjects completed a comprehensive neuropsychological examination, measures of anxiety and depression, and a measure of stressful life events. After controlling for the impact of anxiety, depression, age, and education, stressful life events were related to cognitive impairment only among the HIV-positive subjects. The data were interpreted in the context of previous studies that have demonstrated an adverse effect of stress on the brain and suggest that this adverse impact may be expressed in the setting of a compromised immune system. Furthermore, this analysis suggests several implications for patient management.

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