Format

Send to

Choose Destination
J Affect Disord. 2016 Mar 1;192:153-61. doi: 10.1016/j.jad.2015.12.031. Epub 2015 Dec 22.

Predictors of depression recovery in HIV-infected individuals managed through measurement-based care in infectious disease clinics.

Author information

1
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA. Electronic address: nathaniel_sowa@med.unc.edu.
2
Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC, USA.
3
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

Treatment of comorbid chronic disease, such as depression, in people living with HIV/AIDS (PLWHA) increasingly falls to HIV treatment providers. Guidance in who will best respond to depression treatment and which patient-centered symptoms are best to target is limited.

METHODS:

Bivariable analyses were used to calculate hazard ratios for associations between baseline demographic, mental health-related, and HIV-related factors on time to first depression remission among PLWHA enrolled in a randomized trial of measurement-based antidepressant management. Time-updated factors also were analyzed at time of antidepressant (AD) initiation/adjustment and 8 weeks post AD initiation/adjustment.

RESULTS:

Baseline comorbid depression and anxiety; comorbid depression, anxiety and substance abuse; and generalized anxiety disorder predicted a slower time to first remission. Being on ART but non-adherent, having panic disorder, having a history of a major depressive episode, or having been in HIV care for >10 years prior to study initiation predicted a faster time to first remission. Sleep difficulty or fatigue at the time of AD initiation/adjustment predicted a slower time to remission. In non-remitters at 8 weeks post AD initiation/adjustment, sleep difficulty, anxiety, and fatigue each predicted a slower time to remission.

LIMITATIONS:

Remission was determined by PHQ-9 scores, not diagnostic criteria. The results may apply only to depression recovery in this particular model of treatment. We conducted only exploratory analyses to determine magnitude of effects.

CONCLUSIONS:

Baseline comorbid anxiety with or without substance abuse predicts slower time to depression remission among PLWHA treated in HIV clinics. Targeting anxiety or fatigue at the time of AD initiation/adjustment or sleep difficulty, anxiety, and fatigue at 8 weeks post AD initiation/adjustment could shorten time to depression remission in this model.

KEYWORDS:

Depression; Depression treatment; HIV; Measurement-based care; Remission predictors

PMID:
26724694
PMCID:
PMC4728048
[Available on 2017-03-01]
DOI:
10.1016/j.jad.2015.12.031
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center