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Psychosomatics. 2012 Jan-Feb;53(1):51-7. doi: 10.1016/j.psym.2011.07.004.

Impact of integrated and measurement-based depression care: clinical experience in an HIV clinic.

Author information

1
Department of Psychiatry, Harvard Medical School, Boston, MA, USA. smc9@u.washington.edu

Abstract

BACKGROUND:

Just as in heart disease and diabetes, depression in HIV/AIDS is associated with negative outcomes. While randomized trials have shown the efficacy of treatment for depression in HIV/AIDS, the implementation of evidence-based treatments in real-world settings remains a challenge.

OBJECTIVE:

The objective of this study was to assess the effectiveness of a collaborative, measurement-based approach to depression care, including psychopharmacologic and ancillary psychological therapies in patients with HIV/AIDS and to examine whether or not effective depression treatment would also improve virologic and immunologic outcomes.

METHODS:

This was a retrospective chart review of patients referred for depression to a co-located psychiatry consultation service embedded within an infectious diseases outpatient clinic at an urban tertiary hospital. Data extracted at initial assessment and at last appointment included: axis I diagnosis, whether the patient was on an antidepressant, whether the patient was on a stimulant, BDI-II score, HIV RNA level, and CD4 cell count.

RESULTS:

One hundred twenty-four patient charts were included. Pre- vs. post-treatment analyses revealed significant reductions in depression (average BDI-II score of 23 to 15.7, p = 0.00001) and HIV RNA (14.1 K to 4 K copies/mL, p = 0 .003), and significant increases in CD4 count (518 to 592 cells/μL, p = 0.001). Additionally, more participants were prescribed antidepressants and stimulants at post- vs. pre-treatment.

CONCLUSION:

Taking a collaborative, measurement-based approach to depression care appears to be an effective method for improving depression, virologic, and immunologic outcomes in depressed patients with HIV/AIDS illness.

PMID:
22221721
DOI:
10.1016/j.psym.2011.07.004
[Indexed for MEDLINE]

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