title: Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada.
abstract: CRANIum, a cross-sectional epidemiology study in Western Europe and Canada, was conducted to describe and compare the prevalence of a positive screen for neurocognitive impairment (NCI), depressive symptoms, and anxiety in an HIV-positive population either receiving combination antiretroviral therapy (cART) or who were naive to antiretroviral therapy (ART). HIV-positive patients ≥18 years of age attending a routine medical follow-up visit and able to complete the designated screening tools were eligible for study inclusion. The Brief Neurocognitive Screen was used to assess NCI; depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale. The evaluable patient population (N = 2863) included 1766 men (61.7%) and 1096 (38.3%) women. A total of 1969 patients were cART-experienced (68.8%), and 894 were ART-naive (31.2%). A positive screen for NCI was found in 41.5% of patients (cART-experienced, 42.5%; ART-naive, 39.4%; p = 0.12). A positive screen for depressive symptoms was found in 15.7% of patients (cART-experienced, 16.8%; ART-naive, 13.3%; p = 0.01), whereas 33.3% of patients screened positive for anxiety (cART-experienced, 33.5%; ART-naive, 32.8%; p = 0.71). A greater percentage of women compared with men screened positive for NCI (51.78% vs. 35.1%; p < 0.0001) and depressive symptoms (17.9% vs. 14.3%; p = 0.01). These data suggest that neurocognitive and mood disorders remain highly prevalent in HIV-infected patients. Regular mental health screening in this population is warranted.
authors.affiliation: a Department of Neurology , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Robertson
authors.forename: Carmen
authors.initials: C
authors.lastname: Bayon
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Patricia
authors.initials: P
authors.lastname: McNamara
authors.forename: Christiane
authors.initials: C
authors.lastname: Resch
authors.forename: Jose A
authors.initials: JA
authors.lastname: Muñoz-Moreno
authors.forename: Ranjababu
authors.initials: R
authors.lastname: Kulasegaram
authors.forename: Knud
authors.initials: K
authors.lastname: Schewe
authors.forename: Angel
authors.initials: A
authors.lastname: Burgos-Ramirez
authors.forename: Cristina
authors.initials: C
authors.lastname: De Alvaro
authors.forename: Esther
authors.initials: E
authors.lastname: Cabrero
authors.forename: Matthew
authors.initials: M
authors.lastname: Guion
authors.forename: Michael
authors.initials: M
authors.lastname: Norton
authors.forename: Jean
authors.initials: J
authors.lastname: van Wyk
mesh_terms: D015526:AIDS Dementia Complex / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D002170:Canada; D003072:Cognition Disorders / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: HIV; anxiety; combination antiretroviral therapy; depression; neurocognitive impairment