Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV: A Controlled Trial.
Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV: A Controlled Trial.
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DOI：
10.1097/qai.0000000000000803
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Adolescent Trials Network for HIVAIDS Interventions
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文献类型：
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作者：
Brown 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;Adolescent Trials Network for HIVAIDS Interventions
在艾滋病毒/艾滋病干预青少年试验网络（ATN）的四个站点对青少年和年轻人进行的手动，测量指导的抑郁症治疗的初步测试。美国的研究中心被随机分配到24周的认知行为治疗和药物管理算法（COMB），为艾滋病毒感染者（YLWH）量身定制，或照常治疗（TAU）。TAU站点的青年可以根据需要获得治疗师和药物管理。COMB研究中心临床医生接受了手动干预培训，并参与了监督电话，以监测干预保真度。在44名参与者的研究过程中，与TAU相比，COMB中的参与者报告的抑郁症状较少，p<0.01（通过抑郁症状快速量表测量），并且更有可能缓解，p<0.001（在治疗24周结束时65% vs.10%，在48周最终随访时71% vs.7%）。与TAU相比，COMB参与者接受心理治疗的比例更高（95% vs. 45%，p<0.001），参加更多的会议（12.6 vs. 5，p<0.001）。两组的病毒载量均下降，并与抑郁症状的减轻相关（p<0.05）。为YLWH量身定制的24周手动，测量指导的心理治疗和药物管理算法在实现和维持抑郁症缓解方面比在艾滋病毒护理诊所的常规治疗更有效。鉴于观察到的治疗效果，这种结构化的联合治疗可以传播到医疗诊所，以成功地治疗YLWH，谁是特别容易患抑郁症。
Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at four sites of the Adolescent Trials Network for HIV/AIDS Interventions (ATN). The U.S. 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). 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. Over the course of the study with 44 participants, those in COMB, compared to those in TAU, reported fewer depressive symptoms, p<0.01 (as measured by the Quick Inventory for Depression Symptomatology) 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. 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 treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics in order to successfully treat YLWH, who are at particular risk for depression.