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Apathy, Depression, and Cognitive Performance in HIV-1 Infection

Received January 7, 1997; revised August 15, 1997; accepted August 26, 1997. From the Departments of Psychology and Psychiatry/Biobehavioral Sciences, University of California–Los Angeles, and the Department of Veterans Affairs Medical Center, West Los Angeles, California. Address correspondence to Dr. Castellon, Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, C8-747, University of California–Los Angeles, Los Angeles, CA 90024; e-mail: scastell{at}ucla.edu

The authors examined the relationship between apathy, depression, and cognitive performance in 48 HIV-1–seropositive and 21 seronegative (control) subjects, using reaction time (RT) and working memory tasks. Apathy, but not depression, was associated with working memory deficits among HIV-seropositive subjects. The cognitive-affective component of the Beck Depression Inventory (BDI), but not apathy, was associated with slowing and decreased accuracy on a choice RT task. The BDI cognitive-affective component was more closely associated than the BDI somatic component with both RT slowing and apathy. Results suggest that prominent symptoms of apathy, independent of depression, may be an important indicator of CNS involvement in HIV infection. Total BDI scores showed a less consistent relationship with neurocognitive performance, suggesting that somatic symptomatology is diagnostically ambiguous among HIV-infected subjects.

Key Words: Human Immunodeficiency Virus–Type 1 • Depression • Apathy

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