Efficacy of long-term psychotherapy in the management of persons living with HIV/AIDS

Mugford, J. Gerry (2002) Efficacy of long-term psychotherapy in the management of persons living with HIV/AIDS. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Background -- Since recognition of acquired immunodeficiency syndrome (AIDS) in 1981, an estimated 60 million people, worldwide, have been infected with HIV, and an estimated 25 million people have died of AIDS. In Canada almost 50,000 people are believed to be HIV positive, and each year over 2000 new infections are reported to the Centre for Infectious Disease Prevention and Control (CIDPC). -- It is unknown whether long-term psychotherapy can prevent psychological dysfunction in HIV/AIDS patients. -- The objective of this randomized controlled trial (RCT) was to determine the impact of long-term psychotherapy on depression, the primary outcome measure, hopelessness, coping skills, and CD4 counts in a group of HIV positive subjects who were heterogeneous in respect to their HIV infection, and level of psychological health. -- Methods -- HIV positive adults at a tertiary referral centre were randomly assigned to receive either long-term psychotherapy (N=16), or no psychotherapy with crisis intervention (N=14), irrespective of initial psychological health. -- Results -- The mean age was 30 years, Beck Depression Inventory (BDI) score 22 and CD4 count (cells/μL) 277. At 0, 6 and 12 months, the mean BDI scores were 20, 18 and 26 in the control group, compared to 23 (P = 0.34), 13 (P = 0.016), and 9 (P = 0.006) in the intervention group. -- Mean Beck Hopelessness Scale scores (BHS) were 10, 11 and 13 vs. 10 (P = 0.968), 7(P = 0.027), and 6 (P = 0.005). -- Coping Inventory for Stressful Situations (CISS) scores were: Task, 52, 53 and 55 vs. 52, (P = 0.906), 55 (P = 0.654) and 59 (P = 0.214); Emotion, 50, 46, 49 vs. 51, (P = 0.846), 49 (P = 0.374) and 43 (P - 0.059); Avoidance, 49, 46 and 46 vs. 51 (P = 0.426), 46, (P = 0.036) and 52 (P = 0.062); Distraction, 25, 23 and 24 vs. 24, (P = 0.708), 25 (P = 0.221) and 25 (P = 0.331); Social Diversion, 15,14 and 13 vs. 15, (P = 0.640), 17 (P = 0.031) and 17 (P = 0.031). -- CD4 counts were 333, 243 and 346 vs. 232 (P = 0.25), 262 (P - 0.09), and 259 (P = 0.764). -- Conclusion -- Long-term psychotherapy ameliorates depression and hopelessness in persons living with HIV/AIDS. It may also have a preventative effect.

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