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An Exploratory Study of Ethnicity and Psychotherapy Outcome Among HIV-Positive Patients With Depressive Symptoms

Received September 8, 1999; revised March 24, 2000; accepted March 30, 2000. From the Department of Psychiatry, Weill Medical College of Cornell University, New York, New York. Address correspondence to Dr. Markowitz, Weill Medical College of Cornell University, 525 East 68th Street, Room 1322, New York, NY 10021; e-mail: jcmarko{at}mail.med.cornell.edu

Few data address the relationship between ethnic status and psychotherapy outcome. This study reports data from a four-cell, 16-week controlled clinical trial for HIV-positive patients with depressive symptoms. Patients (N=101) were randomized to 16 weeks of treatment with interpersonal psychotherapy, cognitive-behavioral therapy (CBT), supportive psychotherapy, or imipramine plus supportive psychotherapy. Analyses found an ethnicity-by-treatment interaction wherein African-American subjects (n=18) assigned to CBT (n=4) had significantly poorer outcomes than other patients. This is the first study to uncover an ethnicity-by–specific psychotherapy interaction. Its meaning is unclear. This charged topic requires cautious treatment, particularly given the small sample size in this study, but warrants further research.

Key Words: Human Immunodeficiency Virus–Type 1 (HIV) • Depression • Ethnicity • Psychotherapy Outcome

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