title: Incident major depressive episodes increase the severity and risk of apathy in HIV infection.
abstract: Apathy and depression are inter-related yet separable and prevalent neuropsychiatric disturbances in persons infected with HIV. In the present study of 225 HIV+ persons, we investigated the role of an incident depressive episode in changes in apathy. Participants completed the apathy subscale of the Frontal Systems Behavior Scale during a detailed neuropsychiatric and neuromedical evaluation at visit 1 and again at approximately a 14 month follow-up. The Composite International Diagnostic Interview was used to obtain diagnoses of a new major depressive disorder. At their follow-up visit, participants were classified into four groups depending on their visit 1 elevation in apathy and new major depressive episode (MDE) status. Apathetic participants at baseline with a new MDE (n=23) were at risk for continued, clinically elevated apathy at follow-up, although severity of symptoms did not increase. Of the 144 participants without clinically elevated apathy at visit 1, those who developed a new MDE (n=16) had greater apathy symptomatology at follow-up than those without MDE. These findings suggest that HIV+ individuals, who do not as yet present with elevated apathy, may be at greater risk of elevated psychiatric distress should they experience a new/recurrent depressive episode. Thus, in the context of previous findings, it appears that although apathy and depression are separable constructs, they interact such that a new depressive episode is a risk factor for incident apathy.
authors: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA. Electronic address: rkamat@ucsd.edu.
authors: Rujvi
authors: R
authors: Kamat
authors: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA.
authors: Jordan E
authors: JE
authors: Cattie
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Thomas D
authors: TD
authors: Marcotte
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Steven Paul
authors: SP
authors: Woods
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Donald R
authors: DR
authors: Franklin
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Stephanie H
authors: SH
authors: Corkran
authors: Department of Neurosciences, University of California, School of Medicine, San Diego, La Jolla, CA 92093, USA.
authors: Ronald J
authors: RJ
authors: Ellis
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Igor
authors: I
authors: Grant
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
authors: Robert K
authors: RK
authors: Heaton
mesh_terms: D057565:Apathy; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors
keywords: HIV/AIDS; Longitudinal study; Motivation; Neuropsychiatry