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Neuropsychological performance of HIV-1 infected men with major depression. HNRC Group. HIV Neurobehavioral Research
K J Goggin1, S Zisook, R K Heaton
1San Diego State University, San Diego Joint Doctoral Program in Clinical Psychology, USA.
Insights
Major depressive disorder in men with HIV-1 does not increase the likelihood of significant neurocognitive impairment, though some memory deficits may occur.
Area of Science:
- Neuroscience
- Psychiatry
- Infectious Diseases
Background:
- Major depressive disorder (MDD) is common in individuals with human immunodeficiency virus type 1 (HIV-1).
- Neuropsychological impairment is a known complication of HIV-1 infection.
- The impact of comorbid MDD on neurocognitive function in HIV-1 positive men requires further investigation.
Purpose of the Study:
- To investigate whether HIV-1 infected men with MDD exhibit higher rates of neuropsychological impairment compared to HIV-1 infected non-depressed men.
- To assess the relationship between depression severity and the extent of neurocognitive deficits in this population.
Main Methods:
- A case-control study comparing 47 HIV-1 infected men with MDD to 47 age- and disease-matched HIV-1 infected non-depressed controls.
- Psychiatric assessment using the Structured Clinical Inventory for the DSM-III-R and Hamilton Rating Scale for Depression.
- Comprehensive neuropsychological testing using an expanded Halstead-Reitan Battery across 8 functional domains.
Main Results:
- No significant difference in the prevalence of global neuropsychological impairment between depressed (53%) and non-depressed (38%) HIV-1 infected men.
- Depressed men performed significantly worse on specific memory tests (delayed retention, figure memory) compared to controls.
- The majority of depressed participants (64%) did not exhibit clinically impaired memory, and no correlation was found between depression severity and impairment.
Conclusions:
- Major depressive disorder in HIV-1 infected men is not associated with a higher likelihood of overall clinically significant neurocognitive impairment.
- While some memory deficits may be present in depressed HIV-1 positive men, these do not necessarily indicate global impairment.
- These findings suggest that MDD and HIV-1 related neurocognitive effects may be distinct or interact in complex ways not captured by global impairment measures.
Abstract:
This study sought to determine if human immunodeficiency virus-type 1 (HIV-1) infected depressed men were more likely to be neuropsychologically impaired than their nondepressed counterparts. Subjects were 47 HIV-1 infected men who met DSM-III-R criteria for current major depressive disorder (MDD) and 47 HIV-1 infected nondepressed male controls (M age = 34.2 years) equated on HIV-1 disease severity, demographics, and drug use. The psychiatric interview included the Structured Clinical Inventory for the DSM-III-R, and Hamilton Rating Scale for Depression. The neuropsychological battery included tests covering 8 functional domains based on an expanded Halstead-Reitan Battery. The medical assessment included a history and physical examination, immunologic staging, and evaluation of prescription and recreational drug use. Prevalence of global neuropsychological impairment in the two groups (depressed vs. control) did not differ [53% vs. 38% respectively; chi 2(1, N = 94) = 2.11, p > .05]. While syndromically depressed patients performed less well than nondepressed individuals on memory tests [delayed retention portions of the Story Memory Test: F(1,91) = 5.34, p < .05; and Figure Memory Test: F(1,90) = 4.16, p < .05], the majority of depressed participants (64%) did not have clinically impaired memory. No relationship between neuropsychological impairment and severity of depression was observed. The results suggest that, while HIV-1 infected men with major depression may perform more poorly than nondepressed men on some aspects of memory tasks, they are not more likely to evidence clinically significant neurocognitive impairment.
