Treatment for Depression Among HIV-Infected Youth

Inclusion Criteria:

• Adolescents and young adults ages 16 years and 0 days to 24 years and 364 days at time of enrollment;
• Engaged in care at the participating AMTU;
• Documented HIV infection by medical record review or verbal verification from referring professional and aware of their HIV status;
• Primary diagnosis of non-psychotic depression, either MDD, Depression NOS, or Dysthymia, as defined by DSM-IV criteria and as documented prior to study screening by treating licensed mental health clinician;
• Current depressive symptoms warranting intervention as determined by treating licensed mental health clinician with a score of ≥ 7 on the QIDS-C; NOTE: Youth already receiving treatment for depression with QIDS-C scores ≥ 7 are eligible but those with scores < 7, indicating who minimal ongoing depressive symptoms, are not eligible.
• Ability to understand written and spoken English; and
• Ability and willingness to provide informed consent or assent.

Exclusion Criteria:

• Known or self-reported by participant to have a history of any psychotic disorder (including depression with psychotic features) and/or bipolar I or II disorder;
• Alcohol or substance dependence based on DSM-IV criteria within the past six months as determined by treating licensed mental health clinician. Any cases that are uncertain require Protocol Team approval;
• Pregnant or breast-feeding females;
• Known or self-reported by participant (or parent if available) to have a first degree relative(s) with Bipolar I Disorder;
• Depression and/or suicidal ideation requiring more intensive treatment than the study provides or at immediate risk of being a danger to themselves or others as determined by treating licensed mental health clinician;
• Cognitive limitations, emotional instability or medical illness as determined by treating licensed mental health clinician and/or study coordinator; and
• For Phase II only, previous participation in Phase I.
• For participants at COMB sites only, ongoing CBT for treatment of depressive symptoms at time of study enrollment (e.g., teaching cognitive restructuring using role-play, identification of cognitive distortions, automatic thoughts, dysfunctional attitudes); and NOTE: Youth who received CBT in the past may be considered for enrollment. Any cases that are uncertain require Protocol Team approval.
• For participants at COMB sites only, continuing antidepressant management by a site clinician who is not trained in COMB.