| Background. People living with HIV/AIDS (PHA) experience depression at high rates, and their depression frequently goes both undiagnosed and untreated. For PHA, untreated depression is a grave concern, as it can lead to psychological suffering and worse medical outcomes, including immunosuppressive effects and death. Mindfulness-Based Stress Reduction (MBSR) has been used to improve quality of life and enhance outcomes among many groups. Recent studies indicate that MBSR may enhance immune function in PHA. Mindfulness-Based Cognitive Therapy (MBCT), an 8-week skills-based group intervention, combines MBSR with Cognitive Therapy to prevent depressive relapse. New evidence is emerging to suggest that MBCT may be an effective means of treating acute depression.;Objective. This study sought to determine whether MBCT could effectively treat the symptoms of depression in PHA treated at a community-based HIV/AIDS clinic. It was hypothesized that participation in the MBCT program would result in decreased symptoms of depression and anxiety, improved mindfulness skills, changes in coping style, improvements in quality of life, and no worsening of immunologic markers.;Methods. Twenty-seven PHA were recruited for this study and entered into two consecutive MBCT groups. Participants were assessed prior to beginning the intervention, immediately upon completing it, and at 8-week follow-up. Measures included the Beck Depression Inventory, Second Edition, the Beck Anxiety Inventory, the Brief COPE, the Mindful Attention Awareness Scale, the Medical Outcomes Study Short Form-36, and biological markers of CD4+ T-lymphocytes and HIV-1 RNA viral load.;Within group changes over time were assessed using planned paired t-tests, and effect sizes were calculated using Cohen's d..;Results. Five of the 27 participants completed the study. Despite the small number of completers, significant findings with large effect sizes were noted for depression, mindfulness skills, and quality of life related to the perception of pain and of overall general and physical health, with most results maintained at 8-week follow-up.;Conclusion. MBCT may be an effective treatment for depressive symptoms in PHA. The discussion comments on this study's strengths and limitations and on the feasibility of using MBCT in community-based HIV/AIDS clinics given the high rate of attrition in this study. |
