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Relationship between psychiatric status and frontal–subcortical systems in HIV-infected individuals


Human immunodeficiency virus (HIV)-infected adults frequently evidence both neurocognitive and psychiatric dysfunction. It was hypothesized that apathy and irritability, but not anxiety and depression, are related to HIV effects on frontal–subcortical systems. This hypothesis was evaluated by determining the degree to which these psychiatric features are associated with neurocognitive functioning that is dependent upon frontal–subcortical circuitry and, therefore, thought to be sensitive to the central nervous system effects of HIV. Rating scales assessing irritability, apathy, depression, and anxiety and a dual-task paradigm were administered to 189 HIV-seropositive (HIV+) and 53 HIV-seronegative participants. Deficits in dual-task performance and greater anxiety, depression, apathy, and irritability were observed in HIV+ participants. Simultaneous multivariate regression and communality analyses revealed that only apathy and irritability were associated with dual-task performance in HIV+ participants. Thus, these findings suggest that apathy and irritability, but not depression and anxiety, are likely associated with the effects of HIV on frontal–subcortical circuitry. (JINS, 2007, 13, 549–554.)

Corresponding author
Correspondence and reprint requests to: Michael A. Cole, Ph.D., Department of Psychiatry & Biobehavioral Sciences, UCLA Neuropsychiatric Institute, 760 Westwood Plaza, C8-746, Los Angeles, CA 90095, USA. E-mail:
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Absher, J.R. & Cummings, J.L. (1995). Neurobehavioral examination of frontal lobe functions. Aphasiology, 9, 181192.
Baddeley, A., Della Sala, S., Papagno, C., & Spinnler, H. (1997). Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. Neuropsychology, 11, 187194.
Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893897.
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for Beck Depression Inventory II (BDI-II). San Antonio, TX: Psychology Corporation.
Belsey, D.A., Kuh, E., & Welsch, R.E. (1980). Regression diagnostics: Identifying influential data and sources of collinearity. Hoboken, NJ: Wiley.
Castellon, S.A., Hinkin, C.H., & Myers, H.F. (2000). Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection. Journal of the International Neuropsychological Society, 6, 336347.
Castellon, S.A., Hinkin, C.H., Wood, S., & Yarema, K.T. (1998). Apathy, depression, and cognitive performance in HIV-1 infection. The Journal of Neuropsychiatry and Clinical Neurosciences, 10, 320329.
Chandra, P.S., Desai, G., & Ranjan, S. (2005). HIV and psychiatric disorders. The Indian Journal of Medical Research, 121, 451467.
Cummings, J.L. (1993). Frontal-subcortical circuits and human behavior. Archives of Neurology, 50, 873880.
Cummings, J.L. (1997). Changes in neuropsychiatric symptoms as outcome measures in clinical trails with cholinergic therapies for Alzheimer disease. Alzheimer Disease and Associated Disorders, 11, S1S9.
Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A., & Gornbein, J. (1994). The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.
Della Sala, S., Baddeley, A., Papagno, C., & Spinnler, H. (1995). Dual-task paradigm: A means to examine the central executive. Annals of the New York Academy of Sciences, 769, 161171.
Grant, I., Olshen, R.A., Atkinson, J.H., Heaton, R.K., Nelson, J., McCuthchan, J.A., & Weinrich, J.D. (1993). Depressed mood does not explain neuropsychological deficits in HIV-infected persons. Neuropsychology, 7, 5361.
Hinkin, C.H., Castellon, S.A., & Hardy, D.J. (2000). Dual task performance in HIV-1 infection. Journal of Clinical and Experimental Neuropsychology, 22, 1624.
Hinkin, C.H., Van Gorp, W.G., Satz, P., Weisman, J.D., Thommes, J., & Buckingham, S. (1992). Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. Journal of Clinical and Experimental Neuropsychology, 14, 289297.
Mapou, R.L., Law, W.A., Martin, A., Kampen, D., Salazar, A.M., & Rundell, J.R. (1993). Neuropsychological performance, mood, and complaints of cognitive and motor difficulties in individuals infected with the human immunodeficiency virus. Journal of Neuropsychiatry and Clinical Neurosciences, 5, 8693.
Paul, R.H., Brickman, A.M., Navia, B., Hinkin, C., Malloy, P.F., Jefferson, A.L., Cohen, R.A., Tate, D.F., & Flanigan, T.P. (2005b). Apathy is associated with volume of the nucleus accumbens in patients with HIV. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 167171.
Paul, R., Flanigan, T.P., Tashima, K., Cohen, R., Lawrence, J., Alt, E., Tate, D., Ritchie, C., & Hinkin, C. (2005a). Apathy correlates with cognitive function but not CD4 status in patients with human immunodeficiency virus. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 114118.
Pedhazur, E.J. (1982). Multiple region in behavioral research: Explanation and prediction (2nd ed.). New York: Holt, Renehart & Winston.
Perdices, M., Dunbar, N., Grunseit, A., Hall, W., & Cooper, D.A. (1992). Anxiety, depression and HIV related symptomatology across the spectrum of HIV disease. The Australian and New Zealand Journal of Psychiatry, 26, 560566.
Rabkin, J.G., Ferrando, S.J., Van Gorp, W., Rieppi, R., McElhiney, M., & Sewell, M. (2000). Relationships among apathy, depression, and cognitive impairments in HIV/AIDS. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 451457.
Thompson, P.M., Dutton, R.A., Hayashi, K.M., Toga, A.W., Lopez, O.L., Aizenstein, H.J., & Becker, J.T. (2005). Thinning of the cerebral cortex visualized in HIV/AIDS reflects CD4+ T lymphocyte decline. Proceedings of the National Academy of Sciences of the United States of America, 102, 1564715652.
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Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
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