Associations between Depressive Symptomatology and Neurocognitive Impairment in HIV/AIDS
| Autor: | Daniela Gomez, Noshin Koenig, Esther Fujiwara, Christopher Power, Sarah Tymchuk, M. John Gill |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Sleep Wake Disorders medicine.medical_specialty Human immunodeficiency virus (HIV) HIV Infections Comorbidity Neuropsychological Tests medicine.disease_cause Depressive symptomatology Alberta 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) medicine Humans 030212 general & internal medicine Prospective Studies Psychiatry Depression (differential diagnoses) Depressive Disorder business.industry Depression Neuropsychology Middle Aged medicine.disease Psychiatry and Mental health Editorial Mood disorders Anti-Retroviral Agents Quality of Life Female business Cognition Disorders Neurocognitive 030217 neurology & neurosurgery |
| Zdroj: | Canadian journal of psychiatry. Revue canadienne de psychiatrie. 63(5) |
| ISSN: | 1497-0015 |
| Popis: | Objective:Mood disorders and neurocognitive impairments are debilitating conditions among patients with HIV/AIDS. How these comorbidities interact and their relationships to systemic factors remain uncertain. Herein, we investigated factors contributing to depressive symptomatology (DS) in a prospective cohort of patients with HIV/AIDS in active care that included neuropsychological assessment.Methods:Among patients with HIV/AIDS receiving combination antiretroviral therapy (cART) and ongoing clinical assessments including measures of sleep, health-related quality of life (HQoL), neuropsychological testing, and mood evaluation (Patient Health Questionnaire–9 [PHQ-9]) were performed. Univariate and multivariate analyses were applied to the data.Results:In 265 persons, 3 categories of DS were established: minimal (PHQ-9: 0-4; n = 146), mild (PHQ-9: 5-9; n = 62), and moderate to severe (PHQ-9: 10+; n = 57). Low education, unemployment, diabetes, reduced adherence to treatment, HIV-associated neurocognitive disorders (HAND), low health-related quality of life (HQoL), reduced sleep times, and domestic violence were associated with higher PHQ-9 scores. Motor impairment was also associated with more severe DS. In a multinomial logistic regression model, only poor HQoL and shorter sleep duration were predictive of moderate to severe depression. In this multivariate model, the diagnosis of HAND and neuropsychological performance (NPz) were not predictive of DS.Conclusions:Symptoms of depression are common (45%) in patients with HIV/AIDS and represent a substantial comorbidity associated with multiple risk factors. Our results suggest that past or present immunosuppression and HAND are not linked to DS. In contrast, sleep quality and HQoL are important variables to consider in screening for mood disturbances among patients with HIV/AIDS and distinguishing them from neurocognitive impairments. |
| Databáze: | OpenAIRE |
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