| Publication Abstract Display | | Type: Published Abstract | | Title: Depression is associated with more functional impairment than distal neuropathic pain in HIV-infected individuals in the era of combination antiretroviral therapy. | | Authors: Keltner JR, Vaida F, Ellis R, Moeller-Bertram T, Franklin D, FitzSimons C, Corkran S, Duarte N, Robinson-Papp J, Dworkin R, Clifford D, Gelman B, Simpson D, McArthur J, Mccuthan A, Collier A, Marra C, Morgello S, Atkinson J, Grant I, for the CHARTER Group | | Year: 2011 | | Publication: The American Pain Society’s 30th Annual Scientific Meeting May 19-21, Austin, Texas | | Volume: Issue: Pages: | | Abstract:Distal neuropathic pain (DNP) and depression are prevalent in HIV but their relative impacts on functional impairment are unclear. A better understanding of pain-depression relationships may help identify target populations for intensive treatment. In the multi-site CNS HIV Antiretroviral Treatment Effects Research (CHARTER) study of HIV infected patients (N = 1434) attending 6 university-based clinics, we examined the relationships between DNP, depression (Beck Depression Inventory, BDI), and seven measures of functional impairment (Medical Outcomes Study-HIV, MOS-HIV) in the entire cohort (N=1434), and in the subset with DNP (N=420). Linear regression analysis was used to investigate the separate dependencies of functional impairment upon DNP and upon BDI; while cluster analysis (K-Means, Ward Hierarchial) was used to investigate the dependencies of functional impairment upon both DNP and BDI. For both samples the regression R2 between the seven functional measures vs DNP were .00-.20 while vs BDI were .11-.64. R2 was higher vs BDI than vs DNP for all functional measures and statistically different for 6/7 functional subscales (P<.00015). For both samples the cluster identification overlap for KM and WH cluster techniques was 74-100%. Clusters for the entire cohort were no DNP/low BDI, no DNP/high BDI , high DNP/moderate BDI. Those for the pain subset were low DNP/low BDI, high DNP/moderate BDI, moderate DNP/high BDI. In the entire cohort worst functional scores aggregated in the no DNP/high BDI cluster. In the pain population worst function occurred with moderate DNP/high BDI cluster. These results suggest that although some DNP patients appear to cope well and maintain function, detection and treatment of depression in specific subsets (moderate DNP/high BDI) may be crucial to successful management of impairment. |
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