title: Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection.
abstract: Prominent apathy and/or irritability are frequently observed among individuals infected with the human immunodeficiency virus (HIV). Although these symptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/disorder. The current study examined the prevalence of both apathy and irritability among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performance on neuro-cognitive measures thought to be sensitive to the potential CNS effects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 HIV-seropositive (HIV+) and 21 HIV-seronegative (HIV-) participants who also completed a dual-task reaction time paradigm and the Stroop task. NP disturbance was significantly more prevalent among HIV+ participants compared with HIV- controls and was associated with specific neuro-cognitive deficits suggestive of executive dysfunction. Relative to both HIV- controls and to neuro-psychiatrically intact HIV+ participants, those HIV+ individuals with evidence of prominent apathy and/or irritability showed deficits in dual-task, but not single-task, performance and on the interference condition of the Stroop. Unexpectedly, NP disturbance did not show a robust relationship with HIV disease stage. These results suggest that the presence of prominent apathy and/or irritability among HIV+ individuals may signify greater HIV-associated CNS involvement. In HIV/AIDS, the disruption of frontal-subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance.
authors.affiliation: Department of Psychiatry, UCLA School of Medicine, USA. scastell@ucla.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Castellon
authors.forename: C H
authors.initials: CH
authors.lastname: Hinkin
authors.forename: H F
authors.initials: HF
authors.lastname: Myers
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000523:psychology; D000328:Adult; D001288:Attention; D004193:Discrimination Learning; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology; D015497:HIV-1; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009483:Neuropsychological Tests; D011930:Reaction Time