title: Clinician-assessed depression and HAART adherence in HIV-infected individuals in methadone maintenance treatment.
abstract: BACKGROUND
  The impact of measurement methods on the relationship between depression and HIV treatment adherence has not been adequately examined.
  
  
  OBJECTIVE
  The purpose of this paper is to examine the relationship between clinician- and patient-rated depression and HIV medication adherence.
  
  
  METHODS
  The participants were 91 HIV-infected individuals in methadone maintenance. Depression was assessed via clinician ratings (Clinical Global Impression Scale and Montgomery Asberg Depression Rating Scale) and self-report (Beck Depression Inventory-Short Form). Clinicians rated substance abuse using the Clinical Global Impression Scale and a structured interview. HIV medication adherence was measured over the following 2 weeks using electronic caps.
  
  
  RESULTS
  Each unit increase in the Clinical Global Impression Scale was associated with 75% increased odds of nonadherence (OR=1.75, p=0.002, 95% CI=1.23-2.48). Similarly, for each standard deviation Montgomery Asberg Depression Rating Scale increase, there was a 2.6-fold increased odds of nonadherence (OR=2.60, p=0.001, 95% CI=1.45-4.67). Substance abuse and self-reported depression severity were not significantly related to adherence.
  
  
  CONCLUSIONS
  Clinician-rated depression severity was a strong predictor of nonadherence. Assessment methods may influence the relationship between depression and HIV nonadherence.
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, USA. jeffrey.gonzalez@einstein.yu.edu
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gonzalez
authors.forename: Christina
authors.initials: C
authors.lastname: Psaros
authors.forename: Abigail
authors.initials: A
authors.lastname: Batchelder
authors.forename: Allison
authors.initials: A
authors.lastname: Applebaum
authors.forename: Howard
authors.initials: H
authors.lastname: Newville
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology; D016903:Drug Monitoring
chemical_list: D008691:Methadone