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|Publication Abstract Display|
|Title: Correlates of apathy in a Brazilian cohort of HIV-infected individuals.|
|Authors: Kamat R, Marcotte T, Badiee J, Maich I, Cherner M, de Almeida S, de Pereira AP, Ribiero CE, Barbosa F, Ellis R, and the HNRP Group|
In western cohorts, neuropsychiatric symptoms (e.g., cognitive impairment, depression, and apathy) associated with HIV infection have significant functional and medical consequences. It is not known whether these findings generalize internationally as the correlates and expression of psychiatric distress may differ across cultures. In a cohort of Brazilian HIV+ individuals, we aimed to characterize the relationship between apathy and depression, neuropsychological impairment (NPI), and functional difficulties.
Participants and Methods
Participants were 44 HIV+ and 29 HIV- Brazilians, with 3–19 years of education and 20–69 years of age. They underwent a neuropsychological and neurological evaluation that included self-report measures of depression (Beck Depression Inventory-II; BDI-II), neurocognitive complaints (Patient’s Assessment of Own Functioning Inventory) and declines in instrumental activities of daily living (IADLs; Activities of Daily Living questionnaire). The MINI-plus provided Major depressive disorder (MDD) diagnoses. The neurological evaluation’s apathy item and 3 BDI-II items (i.e., social withdrawal, decision-making, and loss of energy) were summed to generate an apathy z-score (Cronbach’s α=.8).
HIV+ individuals endorsed higher levels of apathy relative to HIV- subjects (p<.001). Apathy was significantly associated with current mood symptoms (r=.60, p<.001), current MDD, t(38)=3.48, p=.001, but not CD4 level, AIDS status or NPI. After adjusting for mood, apathy was significantly correlated with increased IADL dependence (r=.48, p<.001) and cognitive complaints (r=.49, p<.001). In multivariable models with NPI, CD4 level, and current MDD as covariates, apathy significantly predicted IADL dependence (β=.52, p<.01), but not cognitive complaints.
Our Brazilian HIV+ cohort endorsed apathy and depression. Although correlated with depression, apathy was uniquely associated with functional difficulties. Apathy may be worthy of clinical consideration in HIV-infected Brazilians.|
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