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

作者：Larry K. Brown, Kristin Baltrusaitis, Betsy D. Kennard, Graham J. Emslie, Miriam Chernoff, Sarah Buisson, Kathryn Lypen, Laura Whiteley, Shirley Traite, Chelsea Krotje, Kevin Knowles, Ellen Townley, Jaime G. Deville, Megan L. Wilkins, Dan Reirden, Mary E. Paul, Christy Beneri, David E. Shapiro, for the IMPAACT 2002 Team · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2022 · DOI：10.1097/qai.0000000000003058 · 被引用次数：4 · 研究领域：Child and Adolescent Psychosocial and Emotional Development、Bipolar Disorder and Treatment、Maternal Mental Health During Pregnancy and Postpartum

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 ...