Journal of NeuroVirology

, Volume 22, Issue 1, pp 56–65 | Cite as

The role of depression chronicity and recurrence on neurocognitive dysfunctions in HIV-infected adults

  • Lucette A. Cysique
  • Nadene Dermody
  • Andrew Carr
  • Bruce J. Brew
  • Maree Teesson
Article

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.

Keywords

Major depressive disorder Depression HIV AIDS Neuropsychological functions Longitudinal study 

Supplementary material

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ESM 1(PDF 334 kb)
13365_2015_368_MOESM2_ESM.pdf (94 kb)
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Copyright information

© Journal of NeuroVirology, Inc. 2015

Authors and Affiliations

  • Lucette A. Cysique
    • 1
    • 2
    • 3
    • 4
    • 7
  • Nadene Dermody
    • 4
    • 5
  • Andrew Carr
    • 1
    • 3
    • 4
    • 7
  • Bruce J. Brew
    • 1
    • 3
    • 4
    • 7
  • Maree Teesson
    • 7
  1. 1.University of New South WalesSydneyAustralia
  2. 2.Neuroscience Research AustraliaRandwickAustralia
  3. 3.Department of NeurologySt. Vincent’s HospitalSydneyAustralia
  4. 4.St. Vincent’s Hospital Centre for Applied Medical ResearchSydneyAustralia
  5. 5.Department of PsychologyMacquarie UniversitySydneyAustralia
  6. 6.NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research CenterUniversity of New South WalesSydneyAustralia
  7. 7.Infectious Diseases DepartmentSt. Vincent’s HospitalSydneyAustralia

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