Apathy is associated with lower mental and physical quality of life in persons infected with HIV

Abstract

HIV infection is associated with lower health-related quality of life (HRQoL), which is influenced by immunovirological factors, negative affect, neurocognitive impairment, and functional dependence. Although apathy is a common neuropsychiatric sequela of HIV infection, emerging findings regarding its unique role in lower HRQoL have been mixed. The present study was guided by Wilson and Cleary's (1995) model in examining the association between apathy and physical and mental HRQoL in 80 HIV+ individuals who completed a neuromedical examination, neuropsychological assessment, structured psychiatric interview, and a series of questionnaires including the SF-36. Apathy was measured using a composite of the apathy subscale of the Frontal Systems Behavioral Scale and the vigor-activation subscale of the Profile of Mood States. Independent of major depressive disorder, neurocognitive impairment, functional status, and current CD4 count, apathy was strongly associated with HRQoL. Specifically, apathy and CD4 count were significant predictors of physical HRQoL, whereas apathy and depression were the only predictors of mental HRQoL. All told, these findings suggest that apathy plays a unique role in HRQoL and support the importance of assessing and managing apathy in an effort to maximize health outcomes among individuals with HIV disease.

Apathy is associated with poorer abstinence self-efficacy in individuals with methamphetamine dependence

“…While apathy shares features with depression (e.g., reduced insight, energy, and interest in activities; Ishizaki & Mimura, 2011 ), the two constructs may be dissociable ( Paul, 2005 , Paul, 2005 , Tate, 2003 ) and may differ in their clinical impact. Indeed, apathy has important clinical consequences (e.g., NCI, poor treatment compliance, reduced quality of life; Kamat, 2012 , Kamat, 2016 ), and these findings extend this literature to lower abstinence self-efficacy and possible poor substance abuse treatment outcomes. Therefore, although depression is important to consider in substance treatment programs ( Glasner-Edwards, 2009 , Kay-Lambkin, 2011 , Swendsen and Merikangas, 2000 ), our results suggest that assessing and addressing apathy may additionally improve treatment initiation, adherence, and efficacy.…”

Synaptic Connectivity in Medium Spiny Neurons of the Nucleus Accumbens: A Sex-Dependent Mechanism Underlying Apathy in the HIV-1 Transgenic Rat

“…Apathy, one of the neuropsychiatric sequelae of human immunodeficiency virus type 1 (HIV-1), is operationally defined as the quantitative reduction of self-generated voluntary and purposeful (goal-directed) behaviors (Levy and Dubois, 2006 ). Despite treatment with combination antiretroviral therapy (cART), approximately 30%–60% of HIV-1 seropositive individuals exhibit motivational alterations (Kamat et al, 2012 ; Marquine et al, 2014 ); alterations which are associated with functional consequences, including difficulties conducting instrumental activities of daily living (e.g., Kamat et al, 2012 , 2013 , 2016 ; Shapiro et al, 2013 ) and decreased medication adherence (Panos et al, 2014 ). Given the prevalence of apathy in HIV-1 seropositive individuals, there is a critical need to elucidate the structural loci for the actions of HIV-1 viral proteins on goal-directed behaviors.…”

Construct validity of the UCSD performance-based skills assessment-brief version (UPSA-B) in HIV disease

“…Robust predictors of everyday functioning deficits in HIV disease include lower cognitive reserve, neurocognitive impairment, advanced disease (e.g., immunosuppression), and neuropsychiatric complications (e.g., depression, substance abuse) (e.g., Blackstone et al, 2012; Gorman, Foley, Ettenhofer, Hinkin, & van Gorp, 2009; Heaton et al, 2004; Morgan et al, 2012). Critically, these everyday functioning impairments are associated with adverse downstream outcomes such as lower quality of life (Kamat, Woods, Cameron, Iudicello, & the HNRP Group, 2016; Moore et al, 2014; Woods et al, 2015) and increased rates of mortality (Shen, Blank, & Selwyn, 2005). Thus, it is critical to be able to reliably assess for problems of everyday living skills in individuals infected with HIV (Blackstone et al, 2012).…”