Telephone Based CBT for HIV Related Depression: Results of a Randomized Control Trial

Background: Given the burden of depression among those with HIV, there is an urgent need to assess innovative treatment interventions that not only treat depression but do so in a way that allows for increased access to mental health care. Methods: This randomized controlled study sought to determine the depression outcomes of a telephone based cognitive behavioral therapy intervention compared to face-to-face cognitive behavioral therapy targeting low income, urban dwelling, HIV infected people with major depression. The diagnosis of major depression was made using the Mini International Neuropsychiatric Interview. The primary outcome was the HAM-D and the secondary outcome was the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR). Satisfaction and connection to the therapist were also assessed. Assessments occurred at baseline, midpoint and at study conclusion (14 weeks). Results: Participants were randomly assigned to receive 14 week telephone based CBT (n=14) or 14 week face-to-face CBT (n=16). Participants showed significant improvement in depression across both treatments (Ps<0.05). There were no significant time by treatment differences between telephone based CBT and face-to-face CBT on the Ham-D (p=0.34) or the QUID-S (p=0.22). Compared to the control condition, participants receiving telephone-based CBT were as likely to report high degrees of satisfaction and connection to the therapist. Implications: Telephone based CBT can be delivered to low-income, urban dwelling HIV infected people resulting in significant reductions in depression symptoms with high satisfaction.