Treatment of Depressive Symptoms in Human Immunodeficiency Virus–Positive Patients

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Abstract
IN 1988 the late Samuel Perry, MD, inaugurated a 4-cell treatment study for human immunodeficiency virus (HIV)-positive patients with depressive symptoms, modeled on the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP) for medically healthy patients.1 Although depression prevalence among HIV-positive individuals was known to be elevated and response of HIV-positive patients to antidepressant medication was being established,2 little was known about the efficacy of psychotherapy for this population.3 Perry decided to compare interpersonal psychotherapy (IPT),4 cognitive behavioral therapy (CBT),5 supportive psychotherapy (SP), and supportive psychotherapy with imipramine (SWI). When the study began, HIV infection appeared more acutely fatal than it does today. Clinicians wondered whether antidepressant psychotherapies would help patients with seeming "reasons to be depressed."