Incident major depression does not affect neuropsychological functioning in HIV-infected men

Abstract

The diagnosis of lifetime major depressive disorders (MDDs) and of current major depressive episodes (MDEs) are relatively common in HIV-infected individuals, and often are assumed to influence neuropsychological (NP) performance. Although cross-sectional studies of HIV-infected individuals generally have found no systematic link between current MDE or depressive symptoms and NP performance, longitudinal studies are needed to clarify whether incident MDE may impact NP functioning in at least some cases. Two hundred twenty-seven human immunodeficiency virus (HIV)-infected adult men, who did not meet criteria for a current MDE at baseline, participated in a longitudinal NP study for an average of two years. Participants received repeated NP assessments, as well as structured psychiatric interviews to ascertain presence or absence of both lifetime MDD and current MDE. Ninety-eight participants had a lifetime history of MDD, and 23 participants met criteria for incident MDE at one of their follow-up evaluations. Groups with and without lifetime MDD and/or incident MDE had comparable demographics, HIV disease status and treatment histories at baseline, and numbers of intervening assessments between baseline and the final follow-up. Lifetime MDD was associated with greater complaints of cognitive difficulties in everyday life, and such complaints were increased at the times of incident MDE. However, detailed group comparisons revealed no NP performance differences in association with either lifetime or incident major depression. Finally, NP data from consistently nondepressed participants were used to develop "norms for change" and these findings failed to show any increased rates of NP worsening among individuals with incident MDE. Our results suggest that neurocognitive impairment and major depression should be considered as two independent processes.

Neurobehavioral effects of human immunodeficiency virus infection among former plasma donors in rural China

“…The size of the association between current depressive symptoms and NP functioning, however, was clinically trivial (shared variance of less than 3%). This is consistent with similar crosssectional and longitudinal findings from the U.S. (Goggin et al, 1997;Carter et al, 2003;Cysique et al, 2007b), and argues against the possibility that depression occurring in the context of HIV infection is causing the NP impairment. Indeed, the opposite may be the case: some increase in depressed mood may occur in response to awareness of reduced neurocognitive functioning.…”

Variable patterns of neuropsychological performance in HIV-1 infection

“…Also, almost two thirds of the participants in Cluster 1 did not meet criteria for major depressive disorder, so it is unlikely that depression is significantly influencing the neuropsychological status of Cluster 1 participants. This is consistent with findings of several studies that have demonstrated relative independence of major depression and neuropsychological impairment in HIV-infected populations (Cysique et al, 2007;Goggin et al, 1997;Millikin, Rourke, Hallman, & Power, 2003;Richardson et al, 1999). Recent findings have indicated an additive effect on neurocognitive function when HIV infection is associated with comorbid hepatitis C infection Letendre et al, 2005).…”

sychiatry and HIV infection: what changed?

“…Major diagnostic categories (in %) of patients followed in the study centre. Although there are various studies that found no relation between severity of depressive symptoms and neuropsychological impairment [24,25], another suggests a significant relationship between these two variables in HIV-infected patients: with the exception of memory, the greater the severity of depression, the greater is the decline in cognitive domains [26].…”