Cognitive-behavioral group therapy with medication for depressed gay men with AIDS or symptomatic HIV infection

The feasibility and effectiveness of a combination of group cognitive-behavioral therapy and medication for the treatment of depression among gay men with AIDS or symptomatic HIV infection were evaluated.

Fifteen patients diagnosed with DSM-IV major depressive disorder or dysthymia were treated in one of two weekly therapy groups in which cognitive-behavioral therapy had been specially modified for the target population. The majority of these patients, including two who had been on medication before joining the groups, also received antidepressant medication. Thirteen of the 15 patients completed therapy, attending an average of 15 of the 20 therapy sessions.

The group cognitive-behavioral therapy used in this project appeared to be attractive to most patients; retention, attendance, and therapy compliance were good. Depression scores showed substantial decreases from pre- to posttherapy, with further decreases at one-year follow-up. Patients' self-reports indicated that some aspects of the intervention, particularly the focus on cognitive restructuring, were especially valuable in alleviating their depression.

The modified group cognitive-behavioral therapy described in this study report offers a reasonable option for treatment of this clinically challenging group of patients.