title: Combination antiretroviral therapy and improvements in mental health: results from a nationally representative sample of persons undergoing care for HIV in the United States.
abstract: OBJECTIVE
  To test whether mental health improvements observed in a nationally representative sample of 2466 HIV+ persons receiving care in the United States during the dissemination of combination antiretroviral therapy (ART) is a result of global optimism or directly related to treatment.
  
  
  METHODS
  Data were analyzed by means of a linear regression model of the change in psychiatric symptoms from baseline (January 1996-April 1997) to the first follow-up interview approximately 8 months later as a function of changes in CD4+ counts, opportunistic infection treatments, and HIV physical symptoms in the overall sample and separately in participants who maintained ART, initiated ART, never received ART, or transitioned to a less recommended regimen during the study period.
  
  
  RESULTS
  The reduction in psychiatric symptoms was comparable across all treatment groups (p >.05), suggesting a global effect. In patients who initiated or maintained ART, fewer psychiatric symptoms were significantly related to higher CD4+ and fewer opportunistic infection treatments and HIV symptoms, however, suggesting a treatment effect.
  
  
  CONCLUSIONS
  ART appears to be responsible for both a treatment-specific and global improvement in the mental health of HIV+ patients, possibly through the promise of extended survival and a better quality of life.
authors.affiliation: RAND Health, Santa Monica, California 90407-2128, USA. kitty_chan@rand.org
authors.forename: Kitty S
authors.initials: KS
authors.lastname: Chan
authors.forename: Maria
authors.initials: M
authors.lastname: Orlando
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Joyce
authors.forename: Allen L
authors.initials: AL
authors.lastname: Gifford
authors.forename: M Audrey
authors.initials: MA
authors.lastname: Burnam
authors.forename: Joan S
authors.initials: JS
authors.lastname: Tucker
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Sherbourne
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D014481:United States
chemical_list: D019380:Anti-HIV Agents