***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In 1990 , 20 asymptomatic persons diagnosed with the human immunodeficiency virus ( HIV-positive ) and mild-to-moderate depression were divided into 2 comparison groups . One group received structured group therapy plus fluoxetine , while the other received the same therapy plus a placebo .  Affective , neurocognitive , and immune variables were measured before and after the intervention . In the patients receiving group therapy and fluoxetine , its administration did not improve treatment outcome compared to the therapy and placebo group . No significant differences between the two groups were noted on immune variables . However , symptoms of depression decreased in both groups , and both groups showed significant incorporation of the skills in active behavioral coping taught in therapy Objective This r and omized clinical trial was design ed to compare the effects of a theory-based coping effectiveness training ( CET ) intervention with an active informational control ( HIV-Info ) condition and a waiting-list control ( WLC ) condition on psychological distress and positive mood in HIV-seropositive gay men . Material s and Methods The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age , reported depressed mood , and had CD4 levels of 200 to 700 cells/mm3 .  CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year . Participants were assessed at baseline and at 3 , 6 , and 12 months . Data were collected 1992 to 1994 , before the introduction of HAART . Analyses were based on the 128 participants who completed the 3-month assessment . Results After the 3-month intervention phase , when compared with HIV-Info , CET participants showed significantly greater decreases in perceived stress and burnout , and regression analyses indicated that significant increases in coping self-efficacy mediated the improvements in perceived stress and burnout . Compared with WLC , CET participants also showed significantly greater decreases in anxiety , and regression analyses indicated that significant increases in positive states of mind mediated the improvements in anxiety . Significant treatment group differences for positive morale were maintained at 6 and 12 months . In addition , optimism continued to increase in the CET and HIV-Info treatment groups during the maintenance phase . Conclusions CET can be an effective strategy for managing psychological distress and improving positive psychological states in patients confronting chronic illness Mounting evidence suggests that smokers living with HIV/AIDS have a significantly increased risk of numerous adverse health outcomes ( both AIDS- and non-AIDS-related ) compared with HIV-positive nonsmokers . Therefore , efforts to design and implement effective cessation programs for this ever-growing special population are warranted . The present study assessed the effects of a cell phone intervention ( CPI ) on hypothesized mediators ( i.e. , changes in depression , anxiety , social support , and self-efficacy ) demonstrated to influence cessation outcomes in other population s. Ninety-five participants from an inner-city AIDS clinic were r and omized to receive either the CPI or recommended st and ard of care ( RSOC ) smoking cessation treatment . Participants r and omized to the RSOC group ( n=47 ) received brief advice to quit , a 10-week supply of nicotine patches , and self-help material s. Participants r and omized to the CPI group ( n=48 ) received RSOC components plus a series of eight proactive counseling sessions delivered via cell phones . A series of regression analyses ( linear and logistic ) was used to assess the relationships between treatment group , the hypothesized mediators , and biochemically confirmed smoking cessation outcomes . Results indicated that the CPI group experienced greater reductions in anxiety and depression , and increases in self-efficacy compared with the RSOC group . Further , changes in depression , anxiety , and self-efficacy weakened the association between treatment group and cessation outcome . The mediator hypothesis , however , for social support was rejected , as the difference score was not significantly associated with treatment group . These results suggest that the efficacy of the CPI is at least partially mediated by its ability to decrease symptoms of distress while increasing self-efficacy This study examined ethnic differences in response to antidepressant treatment .  One hundred eighteen depressed HIV-positive patients entered an eight-week controlled trial of fluoxetine .  Nineteen percent were black and 14 percent were Latino ; the remaining two-thirds were white . Attrition was greater among Latinos than either blacks or whites . Black patients were more likely than whites to be nonresponders to fluoxetine . Latinos were more likely to respond to placebo compared with blacks and whites . Ethnic groups did not differ in the presence of treatment-emergent side effects BACKGROUND Pharmacological treatment of depression in HIV-infected patients has been found to be effective . This study assessed the efficacy and feasibility of treatment with fluoxetine and the best method of administering the drug to patients with HIV infection . METHODS Sixteen seropositive and 16 seronegative patients , equally matched for age and sex , who had Hamilton Rating Scale for Depression scores of at least 16 and who received at least 20 mg/d of fluoxetine for 8 weeks were studied . RESULTS Depression was alleviated in both groups . However , improvement in the seropositive patients occurred later . INTERPRETATION The results confirm the effectiveness of fluoxetine in treating depression in people with HIV infection . The lack of adverse effects makes this treatment particularly suitable , especially because seronegative people take longer to respond to treatment Background : Most HIV-infected patients attending a consultation-liaison psychiatry service show symptoms of anxiety and depression . The present study sought to evaluate the immediate and long-term efficacy of a structured cognitive-behavioural group therapy reducing anxiety and depression in HIV-infected patients referred to a consultation-liaison psychiatry department , and to identify baseline variables predictive of greater improvement . Methods : Repeated- measures ANOVA was used to analyse changes in the Beck Depression Inventory ( BDI ) and the state subscale of the State/Trait Anxiety Inventory ( STAI ) administered to 39 participants at 4 time points : T1 ( 1 month before beginning the therapy ) , T2 ( during the first session ) , T3 ( during the last session ) and T4 ( 3 months after the last session ) . The therapy consisted of 16 weekly 2-hour sessions following a structured time-limited cognitive-behavioural group psychotherapy programme . Results : During the intervention time ( between T2 and T3 ) an improvement was observed in depression and anxiety , which persisted after the 3-month follow-up period ( between T3 and T4 ) . No changes were observed during baseline ( between T1 and T2 ) . Patients with higher levels of anxiety at baseline showed greater improvement in STAI state subscale scores . Transmission of HIV infection through intravenous drug use was associated with less improvement on the BDI . Conclusions : This is the first report of an ongoing study which suggests long-lasting efficacy of a structured cognitive-behavioural group psychotherapy programme in a heterogeneous sample of HIV-1-infected patients referred to a consultation-liaison psychiatry unit Background : Stress management interventions for HIV-positive persons have been design ed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression . Purpose : We examined the efficacy of a cognitive behavioral stress management ( CBSM ) intervention in combination with medication adherence training ( MAT ) in 130 gay and bisexual men living with HIV infection . Methods : Participants were r and omized to either a 10-week CBSM+MAT intervention ( n = 76 ) or a MAT-only condition ( n = 54 ) . Measures of self-reported adherence , active cognitive coping ( i.e. , acceptance and positive reinterpretation ) , avoidant coping ( i.e. , denial and behavioral disengagement ) , and depressed mood were examined over the 10-week intervention period . Results : Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period , but no changes in active cognitive coping or self-reported adherence were observed . Using path analysis , greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks . We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period . Conclusions : Although denial may be an effective means of distress reduction in the short term , reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term . CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping Background Stress management interventions can reduce symptoms of distress as well as modulate certain immune system components in persons infected with human immunodeficiency virus ( HIV ) . These effects may occur in parallel with reductions in hypothalamic-pituitary-adrenal ( HPA ) axis hormones such as cortisol , which has been related in other work to a down-regulation of immune system components relevant to HIV infection . The present study tested the effects of a multimodal cognitive-behavioral stress management ( CBSM ) intervention on 24-hour urinary free cortisol levels and distressed mood in symptomatic HIV+ gay men . Methods Symptomatic HIV-infected gay men who were r and omized to either a 10-week group-based CBSM intervention or a 10-week wait-list period provided psychological responses and urine sample s pre-post intervention . Results Of the 59 participants providing matched question naire data , men assigned to CBSM ( n=40 ) showed significantly lower posttreatment levels of self-reported depressed affect , anxiety , anger , and confusion than those in the wait-list control group ( n=19 ) . Among the 47 men providing urine sample s ( 34 CBSM , 13 controls ) , those assigned to CBSM revealed significantly less cortisol output as compared to controls . At the individual level , depressed mood decreases paralleled cortisol reductions over this period across the entire sample . Conclusion A time-limited CBSM intervention reduced distress symptoms and urinary free cortisol output in symptomatic HIV+ gay men and greater reductions in some aspects of distress , especially depressed mood , paralleled greater decreases in cortisol over the intervention period . If persisting stressors and depressed mood contribute to chronic HPA axis activation in HIV-infected persons , then interventions such as CBSM , which teaches them to relax , alter cognitive appraisal s , use new coping strategies , and access social support re sources , may decrease distress and depressed mood and normalize HPA axis functioning BACKGROUND Fatigue is a commonly encountered symptom of human immunodeficiency virus ( HIV ) disease , associated with significant psychological and functional morbidity and poor quality of life . Preliminary studies on the treatment of fatigue from the cancer and multiple sclerosis literature suggest that psychostimulants may be effective in reducing fatigue . OBJECTIVE To compare the efficacy of 2 psychostimulant medications , methylpheni date hydrochloride ( Ritalin ) and pemoline ( Cylert ) , with a placebo intervention for the treatment of fatigue in patients with HIV disease . METHODS In this double-blind trial , 144 ambulatory patients with HIV disease and persistent and severe fatigue were r and omized to treatment with methylpheni date , pemoline , or placebo . Medications were titrated up to a maximum dose of 60 mg of methlypheni date hydrochloride , 150 mg of pemoline , or 8 capsules of placebo daily . Fatigue was measured using 2 self-reported rating scales , the Piper Fatigue Scale ( PFS ) and the Visual Analogue Scale for Fatigue ( VAS-F ) . We also used the timed isometric unilateral straight leg-raising task , a measure of muscular endurance . Quality -of-life and psychological well-being measures included the Beck Depression Inventory , the Brief Symptom Inventory , and the 36-Item Short-Form Medical Outcomes Study Health Status Survey . Side effects were monitored using the Systematic Assessment for Treatment Emergent Events and the Extra-pyramidal Symptom Rating Scale . All measures were rated weekly . RESULTS One hundred nine subjects completed the 6-week trial ; 15 patients ( 41 % ) receiving methylpheni date and 12 patients ( 36 % ) receiving pemoline demonstrated clinical ly significant improvement compared with 6 patients ( 15 % ) receiving placebo . Patients receiving methylpheni date or pemoline demonstrated significantly more improvement in fatigue on several self-reported rating scales ( PFS total score , P=.04 ; affective subscale , P=.008 ; sensory subscale , P=.04 ; and VAS-F energy subscale , P=.02 ) . Analysis of the regression slopes by means of hierarchical linear modeling demonstrated a significantly greater rate of improvement in PFS total scores among patients receiving psychostimulants compared with the placebo group ( P=.02 ) . There were no significant differences in the efficacy between methlypheni date and pemoline on any outcome measure studied . Improvement in fatigue was also significantly correlated with improvement in measures of depression , psychological distress , and overall quality of life . Severe side effects were relatively uncommon among this sample , and only hyperactivity or jitteriness occurred significantly more often among subjects receiving active medication . CONCLUSIONS Many patients with HIV- and acquired immunodeficiency syndrome-unrelated fatigue respond favorably to treatment with methylpheni date or pemoline . Both psychostimulants appear to be equally effective and significantly superior to placebo in decreasing fatigue severity with minimal side effects . Moreover , improvement 
    Output:
    
Psychological interventions were particularly effective and in particular interventions that incorporated a cognitive-behavioural component .
Psychotropic and HIV-specific health psychology interventions were generally effective .
Evidence is not clear-cut regarding the effectiveness of physical therapies and psychosocial interventions were generally ineffective .
Interventions that investigated the effects of treatments for HIV and HIV-associated conditions on depression generally found that these treatments did not increase but often decreased depression .
Interventions are both effective and available , although further research into enhancing efficacy would be valuable .