Forty-Eight Week Outcomes of a Site-Randomized Trial of Combined Cognitive Behavioral Therapy and Medication Management Algorithm for Treatment of Depression Among Youth With HIV in the United States.

Autor:	Brown LK; Rhode Island Hospital, Providence, RI.; Alpert Medical School of Brown University, Providence, RI., Baltrusaitis K; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA., Kennard BD; University of Texas Southwestern Medical Center, Dallas, TX., Emslie GJ; University of Texas Southwestern Medical Center, Dallas, TX., Chernoff M; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA., Buisson S; FHI 360, Durham, NC., Lypen K; FHI 360, Durham, NC., Whiteley LB; Alpert Medical School of Brown University, Providence, RI., Traite S; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA., Krotje C; Frontier Science Foundation, Amherst, NY., Knowles K; Frontier Science Foundation, Amherst, NY., Townley E; National Institute of Allergy and Infectious Diseases, National Institute of Health, Rockville, MD., Deville J; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA., Wilkins M; St. Jude Children's Research Hospital, Memphis, TN., Reirden D; University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO., Paul M; Baylor College of Medicine, Texas Children's Hospital, Houston, TX; and., Beneri C; Stony Brook Children's Hospital, Stony Brook, NY., Shapiro DE; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2022 Nov 01; Vol. 91 (3), pp. 296-304. Date of Electronic Publication: 2022 Jul 20.
DOI:	10.1097/QAI.0000000000003058
Abstrakt:	Background: Studies suggest that manualized, measurement-guided, depression treatment is more efficacious than usual care but impact can wane. Our study among youth with HIV (YWH), aged 12-24 years at US clinical research sites in the International Maternal Pediatric Adolescent AIDS Clinical Trials Network, found a significant reduction in depressive symptoms among YWH who received a manualized, measurement-guided treatment. This paper reports outcomes up to 24 weeks after the intervention. Methods: Eligibility included diagnosis of ongoing nonpsychotic depression. Using restricted randomization, sites were assigned to either combination cognitive behavioral therapy and medication management algorithm tailored for YWH or to enhanced standard of care, which provided psychotherapy and medication management. Site-level mean Quick Inventory for Depression Symptomatology Self-Report (QIDS-SR) scores and proportion of youth with treatment response (>50% decrease from baseline) and remission (QIDS-SR ≤ 5) were compared across arms using t tests. Results: Thirteen sites enrolled 156 YWH, with baseline demographic factors, depression severity, and HIV disease status comparable across arms. At week 36, the site-level mean proportions of youth with a treatment response and remission were greater at combination cognitive behavioral therapy and medication management algorithm sites (52.0% vs. 18.8%, P = 0.02; 37.9% vs. 19.4%, P = 0.05), and the mean QIDS-SR was lower (7.45 vs. 9.75, P = 0.05). At week 48, the site-level mean proportion with a treatment response remained significantly greater (58.7% vs. 33.4%, P = 0.047). Conclusions: The impact of manualized, measurement-guided cognitive behavioral therapy and medication management algorithm tailored for YWH that was efficacious at week 24 continued to be evident at weeks 36 and 48. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu