title: The role of depression chronicity and recurrence on neurocognitive dysfunctions in HIV-infected adults.
abstract: Research assessing whether major depressive disorders (MDD) impacts neurocognitive functions in HIV+ persons has yielded inconsistent results. However, none have considered the role of MDD remission, chronicity, and stability on treatment. Ninety-five HIV+ adults clinically stable on combined antiretroviral treatment completed a psychiatric interview, a depression scale, a neuropsychological, daily living, and cognitive complaints assessments at baseline and 18 months. Participants were screened for current (within 12 months of study entry) alcohol and/or substance use disorder. History of alcohol and/or substance abuse disorder prior to the 12 months entry screen and MDD treatments were recorded. Participants were grouped into two psychiatric nomenclatures: (1) lifetime: no MD episode (MDE), single MDE life-event treated and fully remitted, chronic MDD treated and stable, chronic MDD treated and unstable, and baseline untreated MDE; (2) recent: last 2 years MDE (yes or no). We found that lifetime and recent psychiatric history were more strongly associated with decreased in independence in daily living and cognitive complaints than with baseline neuropsychological performance. However, lack of full remission, instability on treatment in chronic MDD, and severity of symptoms in current MDE were factors in whether MDD impacted baseline neuropsychological performance. Depressive symptoms improved at follow-up in those with baseline moderate-severe symptoms, and MDD was not associated with neurocognitive change at 18 months. A history of alcohol and/or substance abuse disorder was significantly more frequent in those with treated and unstable chronic MDD but it was not associated with neuropsychological performance. MDD recurrence, chronicity profiles, and associated comorbidities are keys factors to understand any potential impact on neurocognitive abilities in HIV infection. More comprehensive consideration of these complex effects could serve at constructively updating the HAND diagnostic criteria.
authors: University of New South Wales, Sydney, Australia. lcysique@unsw.edu.au.|Neuroscience Research Australia, PO Box 1165, 139 Barker Street, Randwick, NSW, 2031, Australia. lcysique@unsw.edu.au.|Department of Neurology, St. Vincent's Hospital, Sydney, Australia. lcysique@unsw.edu.au.|St. Vincent's Hospital Centre for Applied Medical Research, Sydney, Australia. lcysique@unsw.edu.au.|Infectious Diseases Department, St. Vincent's Hospital, Sydney, Australia. lcysique@unsw.edu.au.
authors: Lucette A
authors: LA
authors: Cysique
authors: St. Vincent's Hospital Centre for Applied Medical Research, Sydney, Australia.|Department of Psychology, Macquarie University, Sydney, Australia.
authors: Nadene
authors: N
authors: Dermody
authors: University of New South Wales, Sydney, Australia.|Department of Neurology, St. Vincent's Hospital, Sydney, Australia.|St. Vincent's Hospital Centre for Applied Medical Research, Sydney, Australia.|Infectious Diseases Department, St. Vincent's Hospital, Sydney, Australia.
authors: Andrew
authors: A
authors: Carr
authors: University of New South Wales, Sydney, Australia.|Department of Neurology, St. Vincent's Hospital, Sydney, Australia.|St. Vincent's Hospital Centre for Applied Medical Research, Sydney, Australia.|Infectious Diseases Department, St. Vincent's Hospital, Sydney, Australia.
authors: Bruce J
authors: BJ
authors: Brew
authors: Infectious Diseases Department, St. Vincent's Hospital, Sydney, Australia.
authors: Maree
authors: M
authors: Teesson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000437:Alcoholism / Q000503:physiopathology; D002908:Chronic Disease; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000503:physiopathology
keywords: AIDS; Depression; HIV; Longitudinal study; Major depressive disorder; Neuropsychological functions