title: Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV: A Controlled Trial.
abstract: OBJECTIVE
  Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at 4 sites of the Adolescent Trials Network for HIV/AIDS Interventions.
  
  
  METHODS
  The US sites were randomly assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB) tailored for youth living with HIV (YLWH) or to treatment as usual (TAU).
  
  
  METHODS
  Youth at TAU sites had access to therapists and medication management as needed. COMB-site clinicians were trained in the manualized intervention and participated in supervision calls to monitor intervention fidelity.
  
  
  RESULTS
  Over the course of the study with 44 participants, those in COMB, compared with those in TAU, reported fewer depressive symptoms, P < 0.01 (as measured by the Quick Inventory for Depression symptoms) and were more likely to be in remission, P < 0.001 (65% vs. 10% at week 24, end of treatment, and 71% vs. 7% at week 48, final follow-up). A greater proportion of COMB participants received psychotherapy (95% vs. 45%, P < 0.001) and attended more sessions (12.6 vs. 5, P < 0.001) than those in TAU. Viral load decreased in both groups and was associated (P < 0.05) with reduction in depressive symptoms.
  
  
  CONCLUSIONS
  A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH was more effective in achieving and sustaining remission from depression than TAU at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics to successfully treat YLWH, who are at particular risk for depression.
authors.affiliation: *Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI;†Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, TX;‡Westat, Rockville, MD;§The Children's Hospital of Philadelphia, Philadelphia, PA;‖Children's Diagnostic & Treatment Center, Fort Lauderdale, FL;¶NIDA Center for Clinical Trials Network, Bethesda, MD; and#Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Larry K
authors.initials: LK
authors.lastname: Brown
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Kennard
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Emslie
authors.forename: Taryn L
authors.initials: TL
authors.lastname: Mayes
authors.forename: Laura B
authors.initials: LB
authors.lastname: Whiteley
authors.forename: James
authors.initials: J
authors.lastname: Bethel
authors.forename: Jiahong
authors.initials: J
authors.lastname: Xu
authors.forename: Sarah
authors.initials: S
authors.lastname: Thornton
authors.forename: Mary R
authors.initials: MR
authors.lastname: Tanney
authors.forename: Linda A
authors.initials: LA
authors.lastname: Hawkins
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Garvie
authors.forename: Geetha A
authors.initials: GA
authors.lastname: Subramaniam
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Worrell
authors.forename: Laura W
authors.initials: LW
authors.lastname: Stoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000209:etiology / Q000628:therapy*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000928:Antidepressive Agents