Influence of Cognitive Behavioural Therapy on Depression, Medication Adherence and Quality of Life in People Living with HIV/AIDS (PLHIV): A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 FULiang , WUMi-bin ,  HUYan

School of Nursing, Fudan University/Fudan Center for Evidence-based Nursing:A Collaborative Center with Joanna Briggs, Fudan University, Shanghai 200030, China;

Corresponding?author：

HUYan, Email: huyan@fudan.edu.cn

Keywords：

Acquired immunodeficiency syndrome(AIDS); Cognitive behavioural therapy; Depression; Medication adherence; Quality of life; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140124

Video：

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Objective To systematically evaluate the effects of cognitive behavioural therapy (CBT) on improving depression, medication adherence and quality of life in people living with HIV/AIDS (PLHIV). Methods We searched The Cochrane Library (Issue 4, 2013), Ovid-JBI, PubMed, EMbase, PsycARTICLES, CBM and CNKI to collect randomized controlled trials (RCTs) on improving depression, medication adherence and quality of life in PLHIV from the establishment dates to April 30^th 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2. Results A total of 17 RCTs were included, involving 2 163 patients. The results of meta-analysis showed that CBT significantly improved PLHIV's depression (SMD=-0.26, 95%CI-0.41 to-0.10, P=0.001), and quality of life (SMD=-0.57, 95%CI-1.04 to-0.11, P=0.02) in 6 months. Meanwhile, CBT significantly improved PLHIV's medication adherence (WMD=3.98, 95%CI 1.67 to 6.30, P=0.000 8) in the long term. Conclusion CBT is efficacious in improving PLHIV's depression and quality of life in the short term, and improving medication adherence in the long term, compared to standard care.

Citation： FULiang, WUMi-bin, HUYan. Influence of Cognitive Behavioural Therapy on Depression, Medication Adherence and Quality of Life in People Living with HIV/AIDS (PLHIV): A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(6): 734-742. doi: 10.7507/1672-2531.20140124 Copy

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2.	中華人民共和國衛生部, 聯合國艾滋病規劃署, 世界衛生組織. 2011年中國艾滋病疫情評估報告. Available at:http://www.chinaids.org.cn/fzdt/zxdd/201201/t20120129_1745902.htm.
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4.	Hays RD, Cunningham WE, Sherbourne CD, et al. Health-related quality of life in patients with human immunodeficiency virus infection in the United States:results from the HIV Cost and Services Utilization Study. Am J Med, 2000, 108(9):714-722.
5.	楚冬梅.上海地區艾滋病患者生存質量及其影響因素研究.上海:華東師范大學, 2010.
6.	Arnsten JH, Demas PA, Farzadegan H, et al. Antiretroviral therapy adherence and viral suppression in HIV-infected drug users:comparison of self-report and electronic monitoring. Clin Infect Dis, 2001, 33(8):1417-1423.
7.	李宏, 王哲, 崔為國, 等.艾滋病感染者抗病毒治療的服藥依從性及其相關因素的研究.中華流行病學雜志, 2005, 26(7):507-510.
8.	Dimatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment:meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med, 2000, 160(14):2101-2107.
9.	Wang H, Zhou J, He G, et al. Consistent ART adherence is associated with improved quality of Life, CD4 counts, and reduced hospital costs in central China. AIDS Res Hum Retroviruses, 2009, 25(8):757-763.
10.	Yeni PG, Hammer SM, Hirsch MS, et al. Treatment for adult HIV infection:2004 recommendations of the International AIDS SocietyUSA Panel. JAMA, 2004, 292(2):251-265.
11.	Folkman S, Lazarus RS, Gruen RJ, et al. Appraisal, coping, health status, and psychological symptoms. J Pers Soc Psychol, 1986, 50(3): 571-579.
12.	Beck AT. The past and future of cognitive therapy. J Psychother Pract Res, 1997, 6(4):276.
13.	中華醫學會感染病學分會艾滋病學組.艾滋病診療指南(2011版).中華傳染病雜志, 2011, 29(10):629-640.
14.	Gupta A, Durham R. Cognitive behavioural therapy (CBT) for adults with HIV. Cochrane Database Syst Rev, 2007, (2):CD006494.
15.	Jones C, Hacker D, Cormac I, et al. Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database Syst Rev, 2012, (4):CD008712.
16.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. Available from:http://handbook.cochrane.org/.
17.	Carrico AW, Chesney MA, Johnson MO, et al. Randomized controlled trial of a cognitive-behavioral intervention for HIV-positive persons:an investigation of treatment effects on psychosocial adjustment. AIDS Behav, 2009, 13(3):555-563.
18.	Chan I, Kong P, Leung P, et al. Cognitive-behavioral group program for Chinese heterosexual HIV-infected men in Hong Kong. Patient Educ Couns, 2005, 56(1):78-84.
19.	Chesney MA, Chambers DB, Taylor JM, et al. Coping effectiveness training for men living with HIV:results from a randomized clinical trial testing a group-based intervention. Psychosom Med, 2003, 65(6):1038-1046.
20.	Eller LS. Effects of two cognitive-behavioral interventions on immunity and symptoms in persons with HIV. Ann Behav Med, 1995, 17(4):339-348.
21.	Eller LS. Effects of cognitive-behavioral interventions on quality of life in persons with HIV. Int J Nurs Stud, 1999, 36(3):223-233.
22.	Evans S, Fishman B, Spielman L, et al. Randomized trial of cognitive behavior therapy versus supportive psychotherapy for HIV-related peripheral neuropathic pain. Psychosomatics, 2003, 44(1):44-50.
23.	Himelhoch S, Medoff D, Maxfield J, et al. Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS:results of a randomized controlled trial. AIDS Behav, 2013, 17(8):2756-2764.
24.	Inouye J, Flannelly L, Flannelly KJ. The effectiveness of self-management training for individuals with HIV/AIDS. J Assoc Nurses AIDS Care, 2001, 12(5):71-82.
25.	Kelly JA, Murphy DA, Bahr GR, et al. Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons. Am J Psychiatry, 1993, 150(11):1679-1686.
26.	Kraaij V, van Emmerik A, Garnefski N, et al. Effects of a cognitive behavioral self-help program and a computerized structured writing intervention on depressed mood for HIV-infected people:a pilot randomized controlled trial. Patient Educ Couns, 2010, 80(2):200-204.
27.	Molassiotis A, Callaghan P, Twinn SF, et al. A pilot study of the effects of cognitive-behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease. AIDS Patient Care STDS, 2002, 16(2):83-96.
28.	Murphy DA, Lu MC, Martin D, et al. Results of a pilot intervention trial to improve antiretroviral adherence among HIV-positive patients. J Assoc Nurses AIDS Care, 2002, 13(6):57-69.
29.	Murphy DA, Marelich WD, Rappaport NB, et al. Results of an Antiretroviral Adherence Intervention:STAR (Staying Healthy: Taking Antiretrovirals Regularly). J Int Assoc Physicians AIDS Care (Chic), 2007, 6(2):113-124.
30.	Safren SA, O'Cleirigh C, Tan JY, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBTAD) in HIV-infected individuals. Health Psychol, 2009, 28(1):1-10.
31.	Safren SA, O'Cleirigh CM, Bullis JR, et al. Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users:a randomized controlled trial. J Consult Clin Psychol, 2012, 80(3):404-415.
32.	Sikkema KJ, Hansen NB, Kochman A, et al. Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement. Death Stud, 2004, 28(3):187-209.
33.	Weber R, Christen L, Christen S, et al. Effect of individual cognitive behaviour intervention on adherence to antiretroviral therapy:prospective randomized trial. Antivir Ther, 2004, 9(1):85-95.
34.	Jelsma J, Maclean E, Hughes J, et al. An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 2005, 17(5):579-588.
35.	Vosvick M, Koopman C, Gore-Felton C, et al. Relationship of functional quality of life to strategies for coping with the stress of living with HIV/AIDS. Psychosomatics, 2003, 44(1):51-58.

1. ?The Joint United Nations Programme on HIV and AIDS. UNAIDS Report on the global AIDS epidemic 2012. The Joint United Nations Programme on HIV and AIDS, 2012. Available from:http://www.unaids.org/en/resources/documents/2012/name, 76121, en.asp.
2. 中華人民共和國衛生部, 聯合國艾滋病規劃署, 世界衛生組織. 2011年中國艾滋病疫情評估報告. Available at:http://www.chinaids.org.cn/fzdt/zxdd/201201/t20120129_1745902.htm.
3. Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry, 2001, 58(8):721.
4. Hays RD, Cunningham WE, Sherbourne CD, et al. Health-related quality of life in patients with human immunodeficiency virus infection in the United States:results from the HIV Cost and Services Utilization Study. Am J Med, 2000, 108(9):714-722.
5. 楚冬梅.上海地區艾滋病患者生存質量及其影響因素研究.上海:華東師范大學, 2010.
6. Arnsten JH, Demas PA, Farzadegan H, et al. Antiretroviral therapy adherence and viral suppression in HIV-infected drug users:comparison of self-report and electronic monitoring. Clin Infect Dis, 2001, 33(8):1417-1423.
7. 李宏, 王哲, 崔為國, 等.艾滋病感染者抗病毒治療的服藥依從性及其相關因素的研究.中華流行病學雜志, 2005, 26(7):507-510.
8. Dimatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment:meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med, 2000, 160(14):2101-2107.
9. Wang H, Zhou J, He G, et al. Consistent ART adherence is associated with improved quality of Life, CD4 counts, and reduced hospital costs in central China. AIDS Res Hum Retroviruses, 2009, 25(8):757-763.
10. Yeni PG, Hammer SM, Hirsch MS, et al. Treatment for adult HIV infection:2004 recommendations of the International AIDS SocietyUSA Panel. JAMA, 2004, 292(2):251-265.
11. Folkman S, Lazarus RS, Gruen RJ, et al. Appraisal, coping, health status, and psychological symptoms. J Pers Soc Psychol, 1986, 50(3): 571-579.
12. Beck AT. The past and future of cognitive therapy. J Psychother Pract Res, 1997, 6(4):276.
13. 中華醫學會感染病學分會艾滋病學組.艾滋病診療指南(2011版).中華傳染病雜志, 2011, 29(10):629-640.
14. Gupta A, Durham R. Cognitive behavioural therapy (CBT) for adults with HIV. Cochrane Database Syst Rev, 2007, (2):CD006494.
15. Jones C, Hacker D, Cormac I, et al. Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database Syst Rev, 2012, (4):CD008712.
16. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. Available from:http://handbook.cochrane.org/.
17. Carrico AW, Chesney MA, Johnson MO, et al. Randomized controlled trial of a cognitive-behavioral intervention for HIV-positive persons:an investigation of treatment effects on psychosocial adjustment. AIDS Behav, 2009, 13(3):555-563.
18. Chan I, Kong P, Leung P, et al. Cognitive-behavioral group program for Chinese heterosexual HIV-infected men in Hong Kong. Patient Educ Couns, 2005, 56(1):78-84.
19. Chesney MA, Chambers DB, Taylor JM, et al. Coping effectiveness training for men living with HIV:results from a randomized clinical trial testing a group-based intervention. Psychosom Med, 2003, 65(6):1038-1046.
20. Eller LS. Effects of two cognitive-behavioral interventions on immunity and symptoms in persons with HIV. Ann Behav Med, 1995, 17(4):339-348.
21. Eller LS. Effects of cognitive-behavioral interventions on quality of life in persons with HIV. Int J Nurs Stud, 1999, 36(3):223-233.
22. Evans S, Fishman B, Spielman L, et al. Randomized trial of cognitive behavior therapy versus supportive psychotherapy for HIV-related peripheral neuropathic pain. Psychosomatics, 2003, 44(1):44-50.
23. Himelhoch S, Medoff D, Maxfield J, et al. Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS:results of a randomized controlled trial. AIDS Behav, 2013, 17(8):2756-2764.
24. Inouye J, Flannelly L, Flannelly KJ. The effectiveness of self-management training for individuals with HIV/AIDS. J Assoc Nurses AIDS Care, 2001, 12(5):71-82.
25. Kelly JA, Murphy DA, Bahr GR, et al. Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons. Am J Psychiatry, 1993, 150(11):1679-1686.
26. Kraaij V, van Emmerik A, Garnefski N, et al. Effects of a cognitive behavioral self-help program and a computerized structured writing intervention on depressed mood for HIV-infected people:a pilot randomized controlled trial. Patient Educ Couns, 2010, 80(2):200-204.
27. Molassiotis A, Callaghan P, Twinn SF, et al. A pilot study of the effects of cognitive-behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease. AIDS Patient Care STDS, 2002, 16(2):83-96.
28. Murphy DA, Lu MC, Martin D, et al. Results of a pilot intervention trial to improve antiretroviral adherence among HIV-positive patients. J Assoc Nurses AIDS Care, 2002, 13(6):57-69.
29. Murphy DA, Marelich WD, Rappaport NB, et al. Results of an Antiretroviral Adherence Intervention:STAR (Staying Healthy: Taking Antiretrovirals Regularly). J Int Assoc Physicians AIDS Care (Chic), 2007, 6(2):113-124.
30. Safren SA, O'Cleirigh C, Tan JY, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBTAD) in HIV-infected individuals. Health Psychol, 2009, 28(1):1-10.
31. Safren SA, O'Cleirigh CM, Bullis JR, et al. Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users:a randomized controlled trial. J Consult Clin Psychol, 2012, 80(3):404-415.
32. Sikkema KJ, Hansen NB, Kochman A, et al. Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement. Death Stud, 2004, 28(3):187-209.
33. Weber R, Christen L, Christen S, et al. Effect of individual cognitive behaviour intervention on adherence to antiretroviral therapy:prospective randomized trial. Antivir Ther, 2004, 9(1):85-95.
34. Jelsma J, Maclean E, Hughes J, et al. An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 2005, 17(5):579-588.
35. Vosvick M, Koopman C, Gore-Felton C, et al. Relationship of functional quality of life to strategies for coping with the stress of living with HIV/AIDS. Psychosomatics, 2003, 44(1):51-58.

Chinese Journal of Evidence-Based Medicine

Influence of Cognitive Behavioural Therapy on Depression, Medication Adherence and Quality of Life in People Living with HIV/AIDS (PLHIV): A Systematic Review

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