| Publication Abstract Display | | Type: Published Abstract | | Title: Prevalence and 1 year course of psychiatric disorder in HIV-infected, methamphetamine-dependent individuals. | | Authors: Atkinson JH, Cherner M, Heaton RK, Marcotte T, Grant I | | Year: 2003 | | Publication: Psychosomatic Medicine | | Volume: 65 Issue: 1 Pages: A76 | | Abstract:Psychiatric disorder in prevalent in both HIV infection (HIV+) and methamphetamine dependence (METH+). In a prospective cohort study, we compared rates and course of psychopathology and substance abuse, and their relationship to medical illness, in four groups of individuals (N=389) with and without HIV infection and methamphetamine dependence: HIV+/METH+ (N=86), HIV+/METH-negative (N=108), HIV-negative (HIV-)/METH+ (N=114), and demographically matched HIV-negative controls without methamphetamine dependence (HIV-/METH-, N=81). METH+ individuals were required to be in early (two-month) remission at baseline. Participants were evaluated with annual comprehensive psychiatric (Structured Clinical Interview-DSM IV), neuromedical, and neuropsychological (Expanded Halstead-Reitan Battery) assessments. At baseline, lifetime rate of major depression was elevated in across HIV+ and METH+ groups (mean 38%) compared to controls (27%); current major depression was similar across HIV+ and METH+ groups (mean 13%) and higher than study controls (4%). Lifetime and current major depression were not related to diagnosis of AIDS or to impaired neuropsychological test performance. One year follow-up (N=204) revealed higher rates of incident major depression in across METH+ and HIV+ groups (range 19%-30%) than in controls (13%). In those with lifetime methamphetamine dependence, the 12-month rate of relapse to methamphetamine use disorder was similar in HIV+ (34%) and HIV- (30%) individuals. Within METH+/HIV+ individuals, relapse rates were similar in those with and without AIDS. We conclude that risk of depression is high in HIV+/METH+ individuals. Neurocognitive impairment is not explained by depression. Contrary to hopes that risk of relapse to drug abuse may be decreased in HIV+ methamphetamaine abusers as they turn their attention to "health-seeking behaviors," or become ill, risk appears to remain high and be unaffected by HIV disease severity. |
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