The Impact of Depressive Symptoms on Neuropsychological Performance Tests in HIV-Infected Individuals: A Study of the Hawaii Aging with HIV Cohort.

BACKGROUND: The frequency of neurocognitive impairment (NCI) in human immunodeficiency virus (HIV)-infected individuals remains high despite the availability of potent antiretroviral therapy (ART). The concurrence of depression among HIV-infected patients with NCI is common, especially among older individuals. Depression has been implicated as a risk factor for impaired neuropsychological performance (NP). This study explored the relationship between depressive symptoms and NP testing in HIV-infected individuals. METHODS: A cross-sectional analysis was performed within the Hawaii Aging with HIV Cohort, a large prospective study of cognition of older (50 or more years old) compared to younger (20 to 39 years old) HIV-infected individuals. RESULTS: Two hundred and eighty-five HIV infected participants (157 older and 128 younger) were administered a battery of NP tests to measure performance in major cognitive domains. Depressive symptoms were measured using the Beck Depression Inventory (BDI). The rates of depressive symptoms and neuropsychological impairment were similar in older and younger groups. Multivariate analyses revealed depressive symptoms were associated with NP test impairment in the younger group. In the older group, depressive symptoms were not associated with NP. CONCLUSION: This study suggests that depressive symptoms are associated with NP test impairment in younger HIV-infected individuals, but not in older individuals.

[1]  I. Grant,et al.  Neuropsychological performance of HIV-1 infected men with major depression , 1997, Journal of the International Neuropsychological Society.

[2]  H. Myers,et al.  Components of Depression in HIV-1 Infection: Their Differential Relationship to Neurocognitive Performance , 2006, Journal of clinical and experimental neuropsychology.

[3]  Wilbur L. Smith,et al.  Erratum: ″Personality change disorder in children and adolescents following traumatic brain injury,″ (Journal of the International Neuropsychological Society (2000) vol. 6(3) (279-289)) , 1999 .

[4]  A. Beck,et al.  Internal consistencies of the original and revised Beck Depression Inventory. , 1984, Journal of clinical psychology.

[5]  Michael J. Taylor,et al.  The impact of HIV-related neuropsychological dysfunction on driving behavior , 2000, Journal of the International Neuropsychological Society.

[6]  A. Young,et al.  Mood and neuropsychological function in depression: the role of corticosteroids and serotonin , 1998, Psychological Medicine.

[7]  P. Chua,et al.  Depression and neurocognitive performance in individuals with HIV/AIDS: 2‐year follow‐up , 2006, HIV medicine.

[8]  J. Lohr.  Oxygen radicals and neuropsychiatric illness. Some speculations. , 1991, Archives of general psychiatry.

[9]  B. Ances,et al.  Dementia and Neurocognitive Disorders Due to HIV-1 Infection , 2007, Seminars in neurology.

[10]  M. Gill,et al.  HIV infection of the central nervous system: clinical features and neuropathogenesis. , 2008, Neurologic clinics.

[11]  V. Bohr,et al.  Repair of oxidative DNA damage in nuclear and mitochondrial DNA, and some changes with aging in mammalian cells. , 2002, Free radical biology & medicine.

[12]  G. Arendt,et al.  HIV dementia: the role of the basal ganglia and dopaminergic systems , 2000, Journal of psychopharmacology.

[13]  K. Goodkin,et al.  Cognitive Functioning in Younger and Older HIV‐1‐Infected Adults , 2003, Journal of acquired immune deficiency syndromes.

[14]  S. Rourke,et al.  Neurocognitive complaints in HIV-infection and their relationship to depressive symptoms and neuropsychological functioning. , 1999, Journal of clinical and experimental neuropsychology.

[15]  A. Mijch,et al.  Depressive Symptoms Reduced in Individuals with HIV/AIDS Treated with Highly Active Antiretroviral Therapy: A Longitudinal Study , 2000, The Australian and New Zealand journal of psychiatry.

[16]  B. Williams,et al.  Depression in People Living with HIV/AIDS Attending Primary Care and Outpatient Clinics , 2003, The Australian and New Zealand journal of psychiatry.

[17]  A. Mijch,et al.  Depressive Symptoms in Patients with HIV Infection , 1996, The Australian and New Zealand journal of psychiatry.

[18]  Joshua D. Hartzell,et al.  Impact of depression on HIV outcomes in the HAART era. , 2008, The Journal of antimicrobial chemotherapy.

[19]  J. Parsons,et al.  Loneliness and HIV-related stigma explain depression among older HIV-positive adults , 2010, AIDS care.

[20]  R. Bornstein,et al.  Neuropsychological performance in symptomatic and asymptomatic HIV infection. , 1993, AIDS.

[21]  M. Maes,et al.  Construct validity of the Beck Depression Inventory in a depressive population. , 1997, Journal of affective disorders.

[22]  I. Grant,et al.  Effects of HIV-1 infection and aging on neurobehavioral functioning: preliminary findings , 2004, AIDS.

[23]  C. Hinkin,et al.  Medication adherence among HIV+ adults , 2002, Neurology.

[24]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[25]  Andrew J. Saykin,et al.  Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus‐type 1 (HIV‐1) infection , 1991, Neurology.

[26]  C. Hinkin,et al.  Relationship between psychiatric status and frontal–subcortical systems in HIV-infected individuals , 2007, Journal of the International Neuropsychological Society.

[27]  A. Salazar,et al.  Neuropsychological performance, mood, and complaints of cognitive and motor difficulties in individuals infected with the human immunodeficiency virus. , 1993, The Journal of neuropsychiatry and clinical neurosciences.

[28]  I. Katoh,et al.  Azidothymidine causes functional and structural destruction of mitochondria, glutathione deficiency and HIV-1 promoter sensitization. , 2002, European journal of biochemistry.

[29]  C. Sherbourne,et al.  Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. , 2001, Archives of general psychiatry.

[30]  J. O'Callaghan,et al.  Age as a Susceptibility Factor in the Striatal Dopaminergic Neurotoxicity Observed in the Mouse following Substituted Amphetamine Exposure , 2000, Annals of the New York Academy of Sciences.

[31]  O. Selnes,et al.  Higher frequency of dementia in older HIV-1 individuals , 2004, Neurology.

[32]  A. Wu,et al.  Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. , 2004, Psychosomatics.

[33]  G. Glosser,et al.  Relationship between psychiatric disease and neuropsychological impairment in HIV seropositive individuals , 1995, Journal of the International Neuropsychological Society.

[34]  F. Schmitt,et al.  Neuropsychological outcome of zidovudine (AZT) treatment of patients with AIDS and AIDS-related complex. , 1988, The New England journal of medicine.