Implications of apathy and depression for everyday functioning in HIV/AIDS in Brazil.
BACKGROUND
Brazil accounts for the largest number of HIV+ persons in Latin America, and this epidemic poses a significant public health burden in this country. Little is known about the neuropsychiatric and functional consequences of HIV infection in this population.


METHODS
Participants were 43 HIV+ and 29 HIV- individuals who underwent a neuropsychological, psychiatric and neurological evaluation that included self-report measures of mood (Beck Depression Inventory-II; BDI-II), neurocognitive complaints (Patient's Assessment of Own Functioning Inventory) and declines in instrumental activities of daily living (Activities of Daily Living questionnaire). The MINI-Plus generated major depressive disorder (MDD) diagnoses. Apathy, defined as social withdrawal, decision-making difficulty, loss of interest and pleasure, was measured using items from the BDI-II and the neurological evaluation.


RESULTS
When compared with seronegative participants, HIV+ individuals endorsed higher levels of apathy spectrum symptoms. After adjusting for mood and other covariates, apathy significantly predicted worse everyday functioning.


LIMITATIONS
The small sample size, along with the self-report measures used to evaluate apathy and functional difficulties limit the inferences that may be drawn from our findings.


CONCLUSIONS
Our Brazilian HIV+ cohort endorsed apathy and depression as well as significant functional complaints. Although correlated with depression, apathy was uniquely associated with functional difficulties. Clinical attention to apathy and depression in HIV-infected Brazilians may help identify patients at risk for functional difficulties who may benefit from additional support to maintain independence.
['Kamat|Rujvi|R|', 'Morgan|Erin|E|', 'Marcotte|Thomas D|TD|', 'Badiee|Jayraan|J|', 'Maich|Ingrid|I|', 'Cherner|Mariana|M|', 'de Almeida|Sergio|S|', 'de Pereira|Ana Paula|AP|', 'Ribeiro|Clea Elisa|CE|', 'Barbosa|Francisco|F|', 'Atkinson|J Hamp|JH|', 'Ellis|Ronald|R|', '|||']
D000163:Acquired Immunodeficiency Syndrome D000328:Adult D000339:Affect D057565:Apathy D001288:Attention D001938:Brazil D003865:Depressive Disorder, Major D005260:Female D015658:HIV Infections D006679:HIV Seropositivity D006802:Human Activities D006801:Humans D008297:Male D008875:Middle Aged D009483:Neuropsychological Tests D010555:Personality Inventory D011569:Psychiatric Status Rating Scales D057566:Self Report D011795:Surveys and Questionnaires
Apathy Depression Everyday functioning HIV/AIDS Brazil Activities of daily living