TY - JOUR
T1 - Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living with HIV
T2 - A Controlled Trial
AU - Brown, Larry K.
AU - Kennard, Betsy D.
AU - Emslie, Graham J.
AU - Mayes, Taryn L.
AU - Whiteley, Laura B.
AU - Bethel, James
AU - Xu, Jiahong
AU - Thornton, Sarah
AU - Tanney, Mary R.
AU - Hawkins, Linda A.
AU - Garvie, Patricia A.
AU - Subramaniam, Geetha A.
AU - Worrell, Carol J.
AU - Stoff, Laura W.
AU - Kapogiannis, B.
AU - Worrell, C.
AU - Kahana, S.
AU - Davenny, K.
AU - Allison, S.
AU - Emmanuel, [No Value]
AU - Lujan-Zilbermann, [No Value]
AU - Julian, [No Value]
AU - Douglas, [No Value]
AU - Tanney, [No Value]
AU - DiBenedetto, [No Value]
AU - Futterman, [No Value]
AU - Enriquez-Bruce, [No Value]
AU - Campos, [No Value]
AU - Fernandez, [No Value]
AU - Puga, [No Value]
AU - Leonard, [No Value]
AU - Inman, [No Value]
AU - Flynn, [No Value]
AU - Dillard, [No Value]
AU - Wilkins, [No Value]
AU - Wilson, C.
AU - Partlow, C.
AU - Korelitz, J.
AU - Driver, B.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - antidepressants
KW - cognitive behavioral therapy
KW - HIV
KW - major depressive disorder
KW - young adults
KW - youth
UR - http://www.scopus.com/inward/record.url?scp=84951120269&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84951120269&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000000803
DO - 10.1097/QAI.0000000000000803
M3 - Article
C2 - 26761270
AN - SCOPUS:84951120269
SN - 1525-4135
VL - 71
SP - 38
EP - 46
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 1
ER -