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A Telephone-Based Intervention for Depression in HIV Patients: Negative Results from a Randomized Clinical Trial

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Abstract

To determine if a telephone support behavioral intervention improves depressive symptoms among HIV positive outpatients, we enrolled 177 persons with Beck Depression Inventory (BDI) scores scores of ≥10. Participants were randomized to receive up to 12 scheduled psycho-educational calls over 6 months or to an assessment-only control condition. Co-enrolled informal caregivers of HIV patients received the same telephone intervention in parallel. Among the 160 (90.4%) participants who were re-interviewed at 6 months, 56% were male, and 41% were Caucasian, with a mean baseline BDI score of 22.7. Overall, participants’ mean BDI scores improved 5.3 points from baseline, but intervention group differences on depression outcomes including 50% or greater reduction in BDI scores and depression remission were not statistically significant. In the full cohort, men were significantly more likely to improve than women. We conclude that a psycho-educational telephone support intervention did not reduce depressive symptoms for HIV patients more than an assessment-only control condition.

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References

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 7–100.

    Article  Google Scholar 

  • Bing, E. G., Burnham, M. A., Longshore, D., Fleishman, J. A., Sherbourne, C. D., London, A. S., Turner, B. J., Eggan, F., Beckman, R., Vitiello, B., Morton, S. C., Orlando, M., Bozzette, S. A., Ortiz-Barron, L., & Shapiro, M. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry, 58, 721–728.

    Article  PubMed  CAS  Google Scholar 

  • Carrieri, M. P., Hesney, M. A., Spire, B., Loundou, A., Sobel, A., Lepeu, G., Moatti, J. P., & MANIF Study Group. (2003). Failure to maintain adherence to HAART in a cohort of French HIV positive injecting drug users. International Journal of Behavioral Medicine, 10, 1–14.

    Article  PubMed  CAS  Google Scholar 

  • Cisela, J. A., & Roberts, J. E. (2001). Meta-analysis of the relationship between HIV infection and risk of depressive disorders. The American Journal of Psychiatry, 158, 725–730.

    Article  Google Scholar 

  • Cook, J. A., Grey, D., Burke, J., Cohen, M. H., Gutman, A. C., Richardson, J. L., Wilson, T. E., Young, M. A., & Hessol, N. A. (2004). Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV positive women. American Journal of Public Health, 94, 1133–1140.

    Article  PubMed  Google Scholar 

  • Cuijpers, P. (1997). Bibliotherapy in unipolar depression: A meta analysis. Journal of Behavior Therapy and Experimental Psychiatry, 28, 139–147.

    Article  PubMed  CAS  Google Scholar 

  • Elliot, A. J., Uldall, K. K., Bergam, K., Russo, J., Claypoole, K., & Roy-Byrne, P. P. (1998). Randomized, placebo controlled trial of paroxetine versus imipramine in depressed HIV positive outpatients. American Journal of Psychiatry, 155, 367–372.

    Google Scholar 

  • Epstein, N., Ryan, C., Bishop, D., Miller, I., & Keitner, G. (2003). The McMaster model: A view of health family functioning, In F. Walsh (Ed.) Normal family processes: Growing diversity and complexity, 3rd ed. New York, NY: Guilford Press.

    Google Scholar 

  • Herman, D. S., Bishop, D., Anthony, J., Chase, W., Trisvan, E., Lopez, R., & Stein, M. D. Feasibility of a telephone intervention for HIV patients and their informal caregivers. Journal of Clinical Psychology in Medical Settings (in press).

  • Ickovics, J. R., Hamburger, M. E., Vlahov, D., Schoenbaum, E. E., Schuman, P., Boland, R. J., Moore, J., & HIV Epidemiology Research Study Group. (2001). Mortality, CD4 cell count decline, and depressive symptoms among HIV seropositive women: Longitudinal analysis from the HIV epidemiology research study. The Journal of the American Medical Association, 285, 1466–1474.

    Article  CAS  Google Scholar 

  • Irving, G., Bor, R., & Catalan, J. (1995). Psychological distress among gay men supporting a lover or partner with AIDS: A pilot study. AIDS Care, 7(5), 605–617.

    Article  PubMed  CAS  Google Scholar 

  • Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7(2), 113–136.

    Google Scholar 

  • Jones, B. S., Brody, D., Roper, M., & Narrow, W. E. (2003). Prevalance of mood disorders in a national sample of young American adults. Social Psychiatry and Psychiatric Epidemiology, 38, 618–614.

    Article  Google Scholar 

  • Katon, W., & Schulberg, H. (1992). Epidemiology of depression in primary care. General Hospital Psychiatry, 14, 237–247.

    Article  PubMed  CAS  Google Scholar 

  • Lazarus, R., & Folkman, S. (1984). Stress, appraisal and coping. New York, NY: Springer.

    Google Scholar 

  • Lippmann, S., James, W., & Frierson, R. (1993). AIDS and the family: Implications for counseling. AIDS Care, 5(1), 71–78.

    Article  PubMed  CAS  Google Scholar 

  • Markowitz, J. C., Klerman, G. L., Clougherty, K. F., Spielman, L. A., Jacobsberg, L. B., Fishman, B., Frances, A. J., Kocsis, J. H., & Perry, S. W. 3rd (1995). Individual psychotherapies for depressed HIV positive patients. American Journal of Psychiatry, 152, 1504–1509.

    PubMed  CAS  Google Scholar 

  • Markowitz, J. C., Kocsis, J. H., Fishman, B., Spielman, L. A., Jocabsberg, L. B., Frances, A. J., Klerman, G. L., & Perry, S. W. (1998). Treatment of depressive symptoms in human immunodeficiency virus-positive patients. Archives of General Psychiatry, 55, 452–457.

    Article  PubMed  CAS  Google Scholar 

  • Masiak, R., Austin, J., & Heck, L. (1996). Health outcomes of two telephone interventions for patients with rheumatoid arthritis and osteoarthritis. Arthritis and Rheumatism, 39, 1391–1399.

    Article  Google Scholar 

  • McKay, J., Lynch, K., Shepard, D., Ratichek, S., Morrison, R., Koppenhaver, J., & Pettinati, H. M. (2002a). The effectiveness of telephone-based continuing care in the clinical management of alcohol and cocaine use disorders. Journal of Consulting and Clinical Psychology, 72(6), 967–979.

    Article  Google Scholar 

  • McKay, M. M., Harrison, M. E., Gonzales, J., Kim, L., & Quintana, E. (2002b). Multiple family groups for urban children with conduct difficulties and their families. Psychiatric Services, 53, 1467–1468.

    Article  Google Scholar 

  • Mohr, D. C., Hart, S. L., Julian, L., Catledge, C., Honos-Webb, L., Vella, L., & Tasch, E. T. (2005). Telephone-administered psychotherapy for depression. Archives of General Psychiatry, 62, 1007–1014.

    Article  PubMed  Google Scholar 

  • Osgood-Hynes, D. J., Greist, J., Marks, I., Baer, L., Heneman, S., Wenzel, K., Manzo, P. A., Parkin, J. R., Spierings, C. J., Dottl, S. L., & Vitse, H. M. (1998). Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: An open US-UK study. Journal of Clinical Psychiatry, 59(7), 358–365.

    PubMed  CAS  Google Scholar 

  • Pakenham, K. (2001). Application of a stress and coping model to caregiving in multiple sclerosis. Psychology Health and Medicine, 6(1), 13–27.

    Article  Google Scholar 

  • Pakenham, K., Dadds, M., & Lennon, H. (2002). The efficacy of a psychosocial intervention for HIV/AIDS caregiving dyads and individual caregivers: A controlled treatment outcome study. AIDS Care, 14(6), 731–750.

    Article  PubMed  CAS  Google Scholar 

  • Pakenham, K., Dadds, M., & Terry, D. (1995). Carers’ burden and adjustment to HIV. AIDS Care, 7(2), 189–203.

    Article  PubMed  CAS  Google Scholar 

  • Pirraglia, P., Bishop, D., Herman, D., Trisvan, E., Lopez, R., Torgerson, C., Van Hof, A. M., Anderson, B. J., Miller, I., & Stein, M. D. (2005). Caregiver burden and depression among informal caregivers of HIV infected individuals. Journal of General Internal Medicine, 20(6), 510–514.

    Article  PubMed  Google Scholar 

  • Rabkin, J. G., Rabkin, R., Harrison, W., & Wagner, G. (1994). Effects of imipramine on mood and enumerative measures of immune status in depressed patients with HIV illness. American Journal of Psychiatry, 151, 516–523.

    PubMed  CAS  Google Scholar 

  • Rabkin, J. G., Wagner, G. J., & Rabkin, R. (1999). Fluoxetine treatment for depression in patients with HIV and AIDS: a randomized, placebo-controlled trial. American Journal of Psychiatry, 156, 101–107.

    PubMed  CAS  Google Scholar 

  • Savetsky, J. B., Sullivan, L. M., Clarke, J., Stein, M. D., & Samet, J. H. (2001). Evaluation of depressive symptoms in human immunodeficiency virus-infected patients entering primary care. Journal of Nervous and Mental Disease, 189, 76–83.

    Article  PubMed  CAS  Google Scholar 

  • Simoni, J. M., Frick, P. A., Pantalone, A. B., & Turner, B. J. (2003). Antiretroviral adherence interventions: A review of current literature and ongoing studies. Topics in HIV Medicine, 11, 185–198.

    PubMed  Google Scholar 

  • Stein, M., Herman, D., Solomon, D., Anthony, J., Anderson, B., Ramsey, S., & Miller, I. W. (2004). Adherence to treatment of depression in active injection drug users: The Minerva study. Journal of Substance Abuse Treatment, 26(2), 87–93.

    Article  PubMed  Google Scholar 

  • Vitiello, B., Burnam, A. M., Bing, E. G., Beckman, R., & Shapiro, M. F. (2003). Use of psychotropic medications among HIV infected patients in the United States. American Journal of Psychiatry, 160, 547–555.

    Article  PubMed  Google Scholar 

  • Ware, J. E. Jr., & Sherbourne, C. D. (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care, 30(6), 473–483.

    Article  PubMed  Google Scholar 

  • Wight, R. G., Aneshensel, C. S., & Leblanc, A. J. (2003). Stress buffering effects of family supports in AIDS caregiving. AIDS Care, 15, 595–613.

    Article  PubMed  CAS  Google Scholar 

  • Zisook, S., Peterkin, J., Groggin, K. J., Sledge, P., Atkinson, J. H., & Grant, I. (1998). Treatment of major depression in HIV seropositive men. Journal of Clinical Psychiatry, 59, 217–224.

    PubMed  CAS  Google Scholar 

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Acknowledgments

This study was funded in part by National Institute of Health grants MH62719 and MH63051.

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Correspondence to Michael D. Stein.

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Stein, M.D., Herman, D.S., Bishop, D. et al. A Telephone-Based Intervention for Depression in HIV Patients: Negative Results from a Randomized Clinical Trial. AIDS Behav 11, 15–23 (2007). https://doi.org/10.1007/s10461-006-9131-5

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