| Publication Abstract Display | | Type: Poster | | Title: Exploring associations between major depressive disorder history, neurocognitive deficits, and assessment of own symptoms in people living with HIV. | | Authors: Chentsova VO, Wang CX, Iudicello JE, Heaton RK, Grant I | | Date: 02-06-2026 | | Abstract:Objective:
Despite modern antiviral treatments improving outcomes of people living with HIV (PLWH), some continue to evidence neurocognitive (NC) problems. Self-ratings of cognitive difficulties, however, may not correspond to objective deficits indicated by NC testing. Prior studies in PLWH provide evidence that in addition to NC deficits, current depressive symptoms can independently and jointly contribute to greater endorsement of functional challenges. Because major depressive disorder (MDD) can be a recurrent condition, the present study explored whether a history of MDD would directly contribute, and moderate associations of NC deficits identified in testing, with experience of cognitive symptoms even in those not experiencing current MDD.
Participants and Methods:
Participants included 2,552 PLWH from HIV Neurobehavioral Research Program studies between 2003 and 2019, excluding anyone with a current substance use disorder (18-87 years old, 80% male, 46% white non-Hispanic, 77% on ART, 53% virally suppressed). Using diagnoses from the Composite International Diagnostic Interview (CIDI), individuals were split into three groups: no MDD ever (Never, n=1297), historical but no current MDD (Historical, n=909), and current MDD (Current, n=344). Cognitive symptoms were represented using the total difficulties score from the Patients Assessment of Own Functioning Inventory (PAOFI). NC deficits was represented by a global deficit score (GDS) calculated by converting demographically corrected T-scores into deficit scores ranging from 0 (T≥40; normal) to 5 (T<20; severe impairment), and averaging them across a comprehensive test battery. One-way ANOVA was conducted to examine differences in GDS and PAOFI scores across groups. Multiple linear regression including an interaction between MDD Status and GDS was used to model differences in slope of association with PAOFI scores. Additional demographic and HIV-related covariates were selected if significant differences were identified across MDD groups. All analyses were evaluated against a base Type-I error rate of 0.05, with Tukey HSD adjustments for multiple comparisons.
Results:
There were no differences in GDS across MDD groups (F(2,2547)=1.13, p=0.32). Significant differences were identified for PAOFI (F(2,2549)=84.96, p<0.001) with highest symptom ratings by Current (M=10.24), followed by Historical (M=6.63), and Never (M=4.70). There were significant main effects of both GDS (F(1,2546)=141.41, p<0.001) and MDD status group (F(2,2546)=87.43, p<0.001) on PAOFI scores, but no significant interaction was identified to suggest a moderating role of MDD status on the relationship between GDS and PAOFI. Together, GDS and MDD explained 11.1% of the variance in PAOFI scores. Controlling for GDS, MDD status group intercepts, representing different levels of cognitive symptoms, differed significantly across all three groups. At the overall mean GDS of 0.53, estimates of PAOFI scores were lowest for Never (∧β=), higher for Historical (∧β=6.69), and highest for Current (∧β=10.13).
Conclusions:
While MDD history and GDS both were independently associated with reported cognitive symptoms, there was no evidence that their joint presence interacted to augment cognitive symptom ratings. Future research should explore how current depressive symptoms and other psychosocial factors may be contributing to discrepancies between reports of cognitive challenges and verified NC deficits in PLWH with historical or current MDD. |
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