Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV: A Controlled Trial.

TitleEffective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV: A Controlled Trial.
Publication TypePublication
Year of Publication2016
AuthorsBrown LK, Kennard BD, Emslie GJ, Mayes TL, Whiteley LB, Bethel J, Xu J, Thornton S, Tanney MR, Hawkins LA, Garvie PA, Subramaniam GA, Worrell CJ, Stoff LW
Corporate AuthorsAdolescent Trials Network for HIVAIDS Interventions
JournalJ Acquir Immune Defic Syndr
Volume71
Issue1
Pagination38-46
Date Published2016 Jan 01
ISSN1944-7884
KeywordsAdolescent, Adult, Ambulatory Care Facilities, Antidepressive Agents, Cognitive Behavioral Therapy, Combined Modality Therapy, Depressive Disorder, Female, HIV Infections, Humans, Male, Medication Adherence, Psychiatric Status Rating Scales, Young Adult
Abstract

<p><b>OBJECTIVE: </b>Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at 4 sites of the Adolescent Trials Network for HIV/AIDS Interventions.</p><p><b>DESIGN: </b>The US sites were randomly assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB) tailored for youth living with HIV (YLWH) or to treatment as usual (TAU).</p><p><b>METHODS: </b>Youth at TAU sites had access to therapists and medication management as needed. COMB-site clinicians were trained in the manualized intervention and participated in supervision calls to monitor intervention fidelity.</p><p><b>RESULTS: </b>Over the course of the study with 44 participants, those in COMB, compared with those in TAU, reported fewer depressive symptoms, P < 0.01 (as measured by the Quick Inventory for Depression symptoms) and were more likely to be in remission, P < 0.001 (65% vs. 10% at week 24, end of treatment, and 71% vs. 7% at week 48, final follow-up). A greater proportion of COMB participants received psychotherapy (95% vs. 45%, P < 0.001) and attended more sessions (12.6 vs. 5, P < 0.001) than those in TAU. Viral load decreased in both groups and was associated (P < 0.05) with reduction in depressive symptoms.</p><p><b>CONCLUSIONS: </b>A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH was more effective in achieving and sustaining remission from depression than TAU at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics to successfully treat YLWH, who are at particular risk for depression.</p>

DOI10.1097/QAI.0000000000000803
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID26761270
PubMed Central IDPMC4712723
Grant ListU01 HD 040533 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
P30 AI 042853 / AI / NIAID NIH HHS / United States
P30 AI042853 / AI / NIAID NIH HHS / United States