Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons.
OBJECTIVE
Although many studies have documented patterns of emotional distress in persons with HIV disease, there have been few controlled evaluations of therapy outcomes with these individuals. This research evaluated the effects of brief cognitive-behavioral or social support group therapy with this population.


METHODS
Sixty-eight depressed men with HIV infection were randomly assigned to one of three conditions: eight-session cognitive-behavioral groups, eight-session social support groups, or a comparison condition. Before and after intervention and at 3-month follow-up, all participants were individually assessed by using measures of symptoms of distress as well as substance use and sexual practices.


RESULTS
Relative to the comparison group, both the cognitive-behavioral and social support group therapies produced reductions in depression, hostility, and somatization. The social support intervention also produced reductions in overall psychiatric symptoms and tended to reduce maladaptive interpersonal sensitivity, anxiety, and frequency of unprotected receptive anal intercourse, while the cognitive-behavioral intervention resulted in less frequent illicit drug use during the follow-up period. Tests for clinical significance of change particularly underscored benefits of the social support group intervention both at postintervention and at long-term follow-up.


CONCLUSIONS
Brief group therapy for depressed persons with HIV infection produced reductions in symptoms of distress. The two forms of therapy resulted in shared and unique improvements in functioning, although social support groups focused on emotional coping presented greater evidence of clinically significant change. As more persons contract HIV infection and live longer with HIV disease, further research is needed to evaluate outcomes of mental health services with these individuals.
Kelly
J A
JA
Department of Psychiatry and Mental Health Sciences, Medical College of Wisconsin, Milwaukee 53226.
Murphy
D A
DA
Bahr
G R
GR
Kalichman
S C
SC
Morgan
M G
MG
Stevenson
L Y
LY
Koob
J J
JJ
Brasfield
T L
TL
Bernstein
B M
BM
D000328:Adult; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief; D011615:Psychotherapy, Group; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome