Markowitz J C, Kocsis J H, Fishman B, Spielman L A, Jacobsberg L B, Frances A J, Klerman G L, Perry S W
Cornell University Medical College, New York, NY 10021, USA.
Arch Gen Psychiatry. 1998 May;55(5):452-7. doi: 10.1001/archpsyc.55.5.452.
This randomized clinical trial compared 16-week interventions with interpersonal psychotherapy, cognitive behavioral therapy, supportive psychotherapy, and supportive psychotherapy with imipramine for human immunodeficiency virus (HIV)-positive patients with depressive symptoms.
Subjects (N = 101; 85 male, 16 female) with known HIV seropositivity for at least 6 months were randomized to 16 weeks of treatment. Inclusion criteria were 24-item Hamilton Depression Rating Scale score of 15 or higher, clinical judgment of depression, and physical health sufficient to attend outpatient sessions. Therapists were trained in manualized therapies specific for HIV-positive patients. Treatment adherence was monitored.
Subjects randomized to interpersonal psychotherapy (n = 24) and supportive psychotherapy with imipramine (n = 26) had significantly greater improvement on depressive measures than those receiving supportive psychotherapy (n = 24) or cognitive behavioral therapy (n = 27). Similar results appeared in the completer subsample.
Depressive symptoms appear treatable in HIV-positive patients. Interpersonal psychotherapy may have particular advantages as a psychotherapy for patients who have experienced the significant life events of HIV infection.
这项随机临床试验比较了人际心理治疗、认知行为疗法、支持性心理治疗以及支持性心理治疗联合丙咪嗪对伴有抑郁症状的人类免疫缺陷病毒（HIV）阳性患者进行的16周干预效果。
已知HIV血清学阳性至少6个月的受试者（N = 101；85名男性，16名女性）被随机分配接受16周的治疗。纳入标准为汉密尔顿抑郁量表24项评分达15分或更高、临床诊断为抑郁症且身体健康足以参加门诊治疗。治疗师接受了针对HIV阳性患者的手册化治疗培训。对治疗依从性进行了监测。
随机分配至人际心理治疗组（n = 24）和支持性心理治疗联合丙咪嗪组（n = 26）的受试者在抑郁测量指标上的改善明显大于接受支持性心理治疗组（n = 24）或认知行为治疗组（n = 27）。在完成治疗的子样本中也出现了类似结果。
HIV阳性患者的抑郁症状似乎是可治疗的。人际心理治疗对于经历过HIV感染这一重大生活事件的患者而言，作为一种心理治疗方法可能具有特殊优势。
