Impact of Integrated and Measurement-Based Depression Care

Clinical Experience in an HIV Clinic

Shane M. Coleman, Aaron J. Blashill, Rajesh T. Gandhi, Steven Safren, Oliver Freudenreich

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Just as in heart disease and diabetes, depression in HIV/AIDS is associated with negative outcomes. While randomized trials have shown the efficacy of treatment for depression in HIV/AIDS, the implementation of evidence-based treatments in real-world settings remains a challenge. Objective: The objective of this study was to assess the effectiveness of a collaborative, measurement-based approach to depression care, including psychopharmacologic and ancillary psychological therapies in patients with HIV/AIDS and to examine whether or not effective depression treatment would also improve virologic and immunologic outcomes. Methods: This was a retrospective chart review of patients referred for depression to a co-located psychiatry consultation service embedded within an infectious diseases outpatient clinic at an urban tertiary hospital. Data extracted at initial assessment and at last appointment included: axis I diagnosis, whether the patient was on an antidepressant, whether the patient was on a stimulant, BDI-II score, HIV RNA level, and CD4 cell count. Results: One hundred twenty-four patient charts were included. Pre- vs. post-treatment analyses revealed significant reductions in depression (average BDI-II score of 23 to 15.7, p = 0.00001) and HIV RNA (14.1 K to 4 K copies/mL, p = 0 .003), and significant increases in CD4 count (518 to 592 cells/μL, p = 0.001). Additionally, more participants were prescribed antidepressants and stimulants at post- vs. pre-treatment. Conclusion: Taking a collaborative, measurement-based approach to depression care appears to be an effective method for improving depression, virologic, and immunologic outcomes in depressed patients with HIV/AIDS illness.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalPsychosomatics
Volume53
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

HIV
Depression
Acquired Immunodeficiency Syndrome
CD4 Lymphocyte Count
Antidepressive Agents
RNA
Therapeutics
Clinic
Clinical Experience
AIDS/HIV
Urban Hospitals
Ambulatory Care Facilities
Tertiary Care Centers
Communicable Diseases
Psychiatry
Heart Diseases
Appointments and Schedules
Referral and Consultation
Psychology
Cells

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)

Cite this

Impact of Integrated and Measurement-Based Depression Care : Clinical Experience in an HIV Clinic. / Coleman, Shane M.; Blashill, Aaron J.; Gandhi, Rajesh T.; Safren, Steven; Freudenreich, Oliver.

In: Psychosomatics, Vol. 53, No. 1, 01.2012, p. 51-57.

Research output: Contribution to journalArticle

Coleman, Shane M. ; Blashill, Aaron J. ; Gandhi, Rajesh T. ; Safren, Steven ; Freudenreich, Oliver. / Impact of Integrated and Measurement-Based Depression Care : Clinical Experience in an HIV Clinic. In: Psychosomatics. 2012 ; Vol. 53, No. 1. pp. 51-57.
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