The Effect of Cognitive Behavioral Therapy and Changes of Depressive Symptoms Among Thai Adult HIV-Infected Patients

Abstract

Background: In Thailand, the therapeutic effect of cognitive behavioral therapy (CBT) for depression among adult HIV-infected patients has been limitedly studied. Objectives: To determine the association of CBT and changes of depression both immediately post treatment and at 3-month post-treatment. Materials and Methods: A prospective cohort study was conducted at the University Hospital in Thailand. Forty and eighty HIV-infected adults who voluntarily received and did not receive CBT were recruited from the immunology clinic and sexually transmitted diseases clinic between September 2010 and February 2011. Sociodemographic characteristics and medical histories of the participants were collected. A standard Thai Depression Inventory (TDI) was used for evaluation of depressive symptoms. TDI score of 21 or above was interpreted as depression. Other questionnaires included a Montreal Cognitive Assessment questionnaire, standard questionnaire for evaluating life stress event and questionnaire for HIV social support. Results: The mean ages of participants were 44.8 and 43.4 years in the CBT and non-CBT groups respectively. In both group, about half of the subjects were females. Life stress event score in CBT group was significantly higher than the non-CBT group (p < 0.01). At baseline, the mean TDI scores of the CBT group and non-CBT group were 26.7 and 25.3 respectively. After adjustment for age, gender, social support, life stress event and current opportunistic infection; the mean changes of TDI scores in the CBT group were significantly higher than the non-CBT group both immediately [12.13 (95% CI, 10.00-14.26)] (p < 0.001) and at 3-month post-treatment [15.94 (95% CI, 13.69-18.18)] (p < 0.001). Conclusions: CBT is beneficial for treatment of depression among adult HIV-infected patients in Thailand. The beneficial effect of CBT was not only immediate but also sustained at 3-month post-treatment.