Predictors of depression recovery in HIV-infected individuals managed through measurement-based care in infectious disease clinics.
Journal Article (Journal Article)
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.
Full Text
Duke Authors
Cited Authors
- Sowa, NA; Bengtson, A; Gaynes, BN; Pence, BW
Published Date
- March 1, 2016
Published In
Volume / Issue
- 192 /
Start / End Page
- 153 - 161
PubMed ID
- 26724694
Pubmed Central ID
- PMC4728048
Electronic International Standard Serial Number (EISSN)
- 1573-2517
Digital Object Identifier (DOI)
- 10.1016/j.jad.2015.12.031
Language
- eng
Conference Location
- Netherlands