Directly Observed Antidepressant Medication Treatment and HIV Outcomes Among Homeless and Marginally Housed HIV-Positive Adults

A Randomized Controlled Trial

Dados Bibliográficos

ID11038269
AutoresAlexander C Tsai (0000-0001-6397-7917, At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), Dan H Karasic (At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), Gwendolyn P Hammer (At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), Edwin D Charlebois (0000-0001-7237-2119, At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), Kathy Ragland (At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), Alison R Mo (0000-0003-3627-2211, San Francisco General Hospital), Andrew R Moss (At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), James L Sorensen (0000-0003-1713-9650, At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), James Dilley (0000-0002-1108-0048, San Francisco General Hospital), James W Dilley (At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.), David R Bangsberg (0000-0002-6352-8908, At the time of the study, Alexander C. Tsai was with the Langley Porter Psychiatric Institute, University of California, San Francisco. Dan H. Karasic, James L. Sorensen, and James W. Dilley were with the Department of Psychiatry, and Gwendolyn P. Hammer, Edwin D. Charlebois, Kathy Ragland, Andrew R. Moss, and David R. Bangsberg were with the Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California, San Francisco.)
Ano2013
Volume103
Fascículo2
Páginas308-315
Data de publicação2013-02-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAmerican Journal of Public Health (JOURNAL)
Identificadores do periódicoISSN: 0090-0036 • E-ISSN: 1541-0048
EditoraAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2011.300422
PMID22720766
PMCIDPMC3558777
OpenAlexW2095452965
IdiomaEN
Citações recebidas25
Referências citadas48

Objectives. We assessed whether directly observed fluoxetine treatment reduced depression symptom severity and improved HIV outcomes among homeless and marginally housed HIV-positive adults in San Francisco, California, from 2002 to 2008. Methods. We conducted a nonblinded, randomized controlled trial of once-weekly fluoxetine, directly observed for 24 weeks, then self-administered for 12 weeks (n = 137 persons with major or minor depressive disorder or dysthymia). Hamilton Depression Rating Scale score was the primary outcome. Response was a 50% reduction from baseline and remission a score below 8. Secondary measures were Beck Depression Inventory-II (BDI-II) score, antiretroviral uptake, antiretroviral adherence (measured by unannounced pill count), and HIV-1 RNA viral suppression ( Results. The intervention reduced depression symptom severity (b = −1.97; 95% confidence interval [CI] = −0.85, −3.08; P Conclusions. Directly observed fluoxetine may be an effective depression treatment strategy for HIV-positive homeless and marginally housed adults, a vulnerable population with multiple barriers to adherence

Beck Depression Inventory · Confidence interval · Depression (economics) · Fluoxetine · Major depressive disorder · Odds ratio · Pill · Population · Psychiatry · Randomized controlled trial · Bipolar Disorder and Treatment · HIV/AIDS Research and Interventions · Homelessness and Social Issues · Internal Medicine · Medicine · Pharmacology