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J Affect Disord. 2015 Apr 1;175:475-80. doi: 10.1016/j.jad.2015.01.010. Epub 2015 Jan 19.

Incident major depressive episodes increase the severity and risk of apathy in HIV infection.

Author information

1
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.
2
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA.
3
Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
4
Department of Neurosciences, University of California, School of Medicine, San Diego, La Jolla, CA 92093, USA.

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.

KEYWORDS:

HIV/AIDS; Longitudinal study; Motivation; Neuropsychiatry

PMID:
25679203
PMCID:
PMC4386921
DOI:
10.1016/j.jad.2015.01.010
[Indexed for MEDLINE]
Free PMC Article

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