title: Implications of apathy and depression for everyday functioning in HIV/AIDS in Brazil.
abstract: BACKGROUND
  Brazil accounts for the largest number of HIV+ persons in Latin America, and this epidemic poses a significant public health burden in this country. Little is known about the neuropsychiatric and functional consequences of HIV infection in this population.
  
  
  METHODS
  Participants were 43 HIV+ and 29 HIV- individuals who underwent a neuropsychological, psychiatric and neurological evaluation that included self-report measures of mood (Beck Depression Inventory-II; BDI-II), neurocognitive complaints (Patient's Assessment of Own Functioning Inventory) and declines in instrumental activities of daily living (Activities of Daily Living questionnaire). The MINI-Plus generated major depressive disorder (MDD) diagnoses. Apathy, defined as social withdrawal, decision-making difficulty, loss of interest and pleasure, was measured using items from the BDI-II and the neurological evaluation.
  
  
  RESULTS
  When compared with seronegative participants, HIV+ individuals endorsed higher levels of apathy spectrum symptoms. After adjusting for mood and other covariates, apathy significantly predicted worse everyday functioning.
  
  
  CONCLUSIONS
  The small sample size, along with the self-report measures used to evaluate apathy and functional difficulties limit the inferences that may be drawn from our findings.
  
  
  CONCLUSIONS
  Our Brazilian HIV+ cohort endorsed apathy and depression as well as significant functional complaints. Although correlated with depression, apathy was uniquely associated with functional difficulties. Clinical attention to apathy and depression in HIV-infected Brazilians may help identify patients at risk for functional difficulties who may benefit from additional support to maintain independence.
authors.affiliation: San Diego University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA. rkamat@ucsd.edu
authors.forename: Rujvi
authors.initials: R
authors.lastname: Kamat
authors.forename: Erin
authors.initials: E
authors.lastname: Morgan
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: Jayraan
authors.initials: J
authors.lastname: Badiee
authors.forename: Ingrid
authors.initials: I
authors.lastname: Maich
authors.forename: Mariana
authors.initials: M
authors.lastname: Cherner
authors.forename: Sergio
authors.initials: S
authors.lastname: de Almeida
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: de Pereira
authors.forename: Clea Elisa
authors.initials: CE
authors.lastname: Ribeiro
authors.forename: Francisco
authors.initials: F
authors.lastname: Barbosa
authors.forename: J Hamp
authors.initials: JH
authors.lastname: Atkinson
authors.forename: Ronald
authors.initials: R
authors.lastname: Ellis
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000523:psychology; D000328:Adult; D000339:Affect; D057565:Apathy; D001288:Attention; D001938:Brazil; D003865:Major Depressive Disorder / Q000209:etiology* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006679:HIV Seropositivity / Q000150:complications / Q000523:psychology; D006802:Human Activities / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D011795:Surveys and Questionnaires