Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Jan 1;71(1):38-46.
doi: 10.1097/QAI.0000000000000803.

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

Larry K Brown  1 , Betsy D Kennard, Graham J Emslie, Taryn L Mayes, Laura B Whiteley, James Bethel, Jiahong Xu, Sarah Thornton, Mary R Tanney, Linda A Hawkins, Patricia A Garvie, Geetha A Subramaniam, Carol J Worrell, Laura W Stoff; Adolescent Trials Network for HIVAIDS Interventions
Collaborators, Affiliations
Randomized Controlled Trial

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

Larry K Brown et al. J Acquir Immune Defic Syndr. .

Abstract

Objective: 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.

Design: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest:

For the remaining authors, none were declared.

Figures

Figure 1
Figure 1
Participant consent, randomization, and retention (CONSORT Flowchart) *Delay in site approval for 36 week follow-up reduced eligible participant
Figure 2
Figure 2
Quick Inventory of Depression Symptomatology (QIDS) over Time* and by Condition *Note: QIDS-C not administered at 36 and 48 weeks
See this image and copyright information in PMC

References

    1. Gaughan DM, Hughes MD, Oleske JM, Malee K, Gore CA, Nachman S, et al. Psychiatric hospitalizations among children and youths with human immunodeficiency virus infection. Pediatrics. 2004;113:e544–e551. - PubMed
    1. Brown LK, Whiteley L, Harpe GW, Nichols S, Nieves A. The ATN 086 Protocol Team for The Adolescent Medicine Trials Network for HIV/AIDS Interventions. Psychological symptoms among 2032 youth living with HIV: A multisite study. AIDS Patient Care STDs. in press. - PMC - PubMed
    1. Martinez J, Hosek SG, Carleton RA. Screening and Assessing Violence and Mental Health Disorders in a Cohort of Inner City HIV-Positive Youth between 1998–2006. AIDS Patient Care STDs. 2009;23(6):469–475. - PMC - PubMed
    1. Pao M, Lyon M, D'Angelo LJ, Schuman WB, Tipnis T, Mrazek DA. Psychiatric diagnoses in adolescents seropositive for the human immunodeficiency virus. Arch Pediatr Adolesc Med. 2000;154:240–244. - PubMed
    1. Reisner SL, Mimiaga MJ, Skeer M, Perkovich B, Johnson CV, Safren SA. A review of HIV antiretroviral adherence and intervention studies among HIV-infected youth. Top HIV Med. 2009;17(1):14–25. - PMC - PubMed

Publication types

Substances