Antidepressant Treatment and Adherence to Combination Antiretroviral Therapy among Patients with AIDS and Diagnosed Depression

Walkup, James; Wei, Wenhui; Sambamoorthi, Usha; Crystal, Stephen

doi:10.1007/s11126-007-9055-x

Cited by 91 publications

(38 citation statements)

References 42 publications

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“…The current literature on adherence notes that clinicians should implement appropriate interventions to improve adherence. For example, use of antidepressants also improved adherence among depressed HIV infected individuals [18,19]. Similarly, Methadone Maintenance Treatment improved adherence among HIV infected individuals [28].…”

Section: Discussionmentioning

confidence: 97%

“…Further, the treatment of depression improves cognitive functioning [9,10]. A number of studies found a positive effect of antidepressants on the adherence of HIV medication [17][18][19]. However, none of the studies examined the variation in the effect of antidepressant use with medication complexity on medication adherence among depressed individuals.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Antidepressant Treatment on Antiretroviral Regimen Adherence Among Depressed HIV-Infected Patients

Kumar

Encinosa

2009

Psychiatr Q

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This study examined whether the relationship between HAART medication adherence and antidepressant treatment varied with HAART regimen complexity. The analysis included 1,192 respondents to the HIV Cost and Service Utilization Study (HCSUS) who were taking HAART. Self-reported past-week HAART adherence, antidepressant use, current mental health status, and an aggregate measure of regimen complexity were used in the analysis. Regression models with interactions between antidepressant treatment of mental health problems, poor emotional well-being or depressive symptoms, and medication complexity were estimated to assess differential associations with adherence. Irrespective of antidepressant treatment, poor mental health status was negatively associated with HAART medication adherence. However, only untreated higher depressive symptoms were strongly associated with maladherence to HAART medication (OR = 0.72 at P < 0.05). Medication complexity was strongly associated with maladherence to HAART medication (OR = 0.96 with P < 0.05) in the model including emotional well-being; and weakly associated with maladherence (OR = 0.97 and P < 0.07) in the model including depressive and/or anxiety symptoms. However, as HAART medication complexity increased, adherence was higher among individuals with poorer mental health but using antidepressants compared to those with better mental health (OR = 1.09 with P < 0.05 in the model including emotional well-being; OR = 1.09 and P < 0.05 in the model including depressive and/or anxiety symptoms), and compared to those with poorer mental health but not using antidepressants (OR = 1.09, P = 0.08 in the model including emotional well-being, and OR = 1.12, P < 0.05 in model including depressive and/or anxiety symptoms). In conclusion, while individuals with poorer mental health generally have poor HAART adherence, their adherence improved with the use of antidepressants as the HAART complexity increased.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Effects of Antidepressant Treatment on Antiretroviral Regimen Adherence Among Depressed HIV-Infected Patients

Kumar

Encinosa

2009

Psychiatr Q

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“…Mental illness among individuals with HIV has been associated with negative outcomes including decreased quality of life, 4,[6][7][8] AIDS-related morbidity and mortality, 9,10 delayed entry into medical care, 5,11,12 poorer medication adherence, 4,8,[13][14][15] risky sexual and drug use behaviors 12,16 and substantial costs including productivity loss and health care expenditures. 10,17,18 Mental health treatment, including mental health counseling and psychopharmacologic treatment, has been associated with improvements in mental health functioning [19][20][21][22][23][24][25][26] as well as greater HIV-related medication use and adherence 10,19,[27][28][29][30][31] and higher CD4 counts. 24,32 Although some studies have found psychopharmacologic treatment to have benefit in improving psychiatric symptoms and medication use, 27,31,32 one study found no association of psychopharmacologic treatment alone on HIV medication use.…”

Section: Introductionmentioning

confidence: 99%

“…10,17,18 Mental health treatment, including mental health counseling and psychopharmacologic treatment, has been associated with improvements in mental health functioning [19][20][21][22][23][24][25][26] as well as greater HIV-related medication use and adherence 10,19,[27][28][29][30][31] and higher CD4 counts. 24,32 Although some studies have found psychopharmacologic treatment to have benefit in improving psychiatric symptoms and medication use, 27,31,32 one study found no association of psychopharmacologic treatment alone on HIV medication use. 29 This study found that mental health counseling alone or in conjunction with psychopharmacologic treatment was associated with greater HIV medication utilization.…”

Section: Introductionmentioning

confidence: 99%

In-Home Mental Health Treatment for Individuals with HIV

Reif

Pence

LeGrand

et al. 2012

AIDS Patient Care and STDs

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Mental health problems are highly prevalent among individuals with HIV and are consistently associated with negative health outcomes. However, mental illness often remains untreated due to significant psychosocial and physical barriers to treatment participation. The Collaborative HIV/AIDS Mental Health Program (CHAMP) assessed the outcomes associated with providing 9 months of in-home mental health counseling for 40 individuals with HIV and a Major Axis I mental disorder. The evidence-based Illness Management and Recovery Model was adapted for use with HIV-positive individuals for the study using a community-based participatory research approach. Study participants were surveyed at baseline, 5 and 9 months to assess for changes in health outcomes. Thirty-five percent of study participants were female, 80% African American, 33% self-identified as MSM and the average participant age was 43. Forty percent of participants were on psychotropic medication at baseline. Participants had an average of 8 counseling visits (median 9). Statistically significant decreases in the global Brief Symptom Inventory (BSI) score and a number of BSI symptoms dimensions including anxiety, depression, obsessive compulsive, phobic anxiety and hostility were detected, indicating a reduction of psychiatric symptoms. Statistically significant improvement was also identified for the SF-12 mental health scale, adaptive coping, overall social support and emotional support. No differences in psychiatric outcomes were identified by gender, race/ethnicity, or sexual preference. Findings from the CHAMP Study suggest that the use of in-home mental health treatment may be beneficial in engaging and treating HIV-positive individuals with comorbid mental health disorders.

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“…2,[27][28][29][30] Several reports indicate that cellular immune responses in women may be altered with depression. 29 Fortunately, treatment of depression pharmacologically or through other behavioral interventions can be beneficial with demonstrated improved clinical outcomes and HAART adherence; 12,[31][32][33][34][35][36] however, differential use of antidepressants has been documented. [37][38][39] The relationship of depression and its treatment and HAART adherence is a dynamic one and longitudinal evaluations of HIV-infected persons in the evolving chronic disease model of care are needed.…”

mentioning

confidence: 99%

Sadness in the SUN: Using Computerized Screening to Analyze Correlates of Depression and Adherence in HIV-Infected Adults in the United States

Tedaldi

Berg-Wolf

Richardson

et al. 2012

AIDS Patient Care and STDs

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We used a standardized screening tool to examine frequency of depression and its relation to antiretroviral medication adherence among HIV-infected persons on highly active antiretroviral therapy (HAART) in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study). This is a prospective observational cohort of 700 HIV-infected patients enrolled between March 2004 and June 2006 in four U.S. cities, who completed a confidential audio computer-assisted self-interview [ACASI] with behavioral risk and health-related questions at baseline and 6-month follow-up visits, including the nine-question PRIME-MD depression screener and a validated 3-day antiretroviral adherence question. Among 539 eligible participants receiving HAART, 14% had depression at baseline (22% women, 12% men). In multivariable analysis using generalized estimating equations (GEE) to account for repeated measurements through 24 months of follow-up, persons who reported depression on a given ACASI were twice as likely to report nonadherence to antiretrovirals on the same ACASI (Odds ratio [OR] 2.02, 95% CI: 1.15, 3.57] for mild/moderate depression versus none); such persons were also less likely to have HIV viral load < 400 copies/mL. Self-administered computerized standardized screening tools can identify at-risk individuals with depression who may benefit from interventions to improve antiretroviral adherence.

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Antidepressant Treatment and Adherence to Combination Antiretroviral Therapy among Patients with AIDS and Diagnosed Depression

Abstract: Background-The prevalence of depression is elevated among HIV-infected individuals and there is evidence that depression exerts a negative impact on HIV medication adherence.

Cited by 91 publications

References 42 publications

Effects of Antidepressant Treatment on Antiretroviral Regimen Adherence Among Depressed HIV-Infected Patients

Effects of Antidepressant Treatment on Antiretroviral Regimen Adherence Among Depressed HIV-Infected Patients

In-Home Mental Health Treatment for Individuals with HIV

Sadness in the SUN: Using Computerized Screening to Analyze Correlates of Depression and Adherence in HIV-Infected Adults in the United States

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