Association between self-report of cognitive: Impairment, HIV status, and cocaine use in a sample of cocaine-dependent methadone-maintained patients

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 affective 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. (C) 1997 Elsevier Science Ltd.