Randomized Controlled Trial of Stress Management Training in HIV (SWISSIT)

Randomized Controlled Trial of Stress Management Training in Individuals With HIV Infection

The introduction of highly active antiretroviral therapy (HAART) has dramatically changed the consequences of an HIV infection, which is now viewed as a chronic disease. As in other chronic diseases, emotional distress and depressive symptoms are highly prevalent in HIV-infected patients. Psychological factors such as these have been associated with lower quality of life, lower adherence to therapy and also with a higher risk for mortality and disease progression. Psychosocial interventions, such as group-based cognitive behavioral stress management (CBSM) training, have been shown to reduce distress and psychological symptoms in HIV-infected patients. These psychosocial effects are paralleled by changes in physiological parameters, such as cortisol, DHEA-S, testosterones, catecholamines, and naïve T-cell counts. While these results are congruent with recent evidence of the interaction between psychological, neuroendocrine and immunological parameters in HIV-infected patients, it needs to be shown whether the reported effects hold true in the HAART era. Most importantly, it also needs to be ascertained whether these interventions have an impact on immunological and virological HIV parameters as well as on mortality and morbidity in HIV patients. We propose a randomized controlled one-year prospective evaluation of a group-based CBSM training in 80 HIV-infected patients. Participating patients will be recruited at cooperating centers of the Swiss HIV Cohort Study and randomly assigned to CBSM training or waiting control group condition. At baseline, post-training and two follow-up (6 and 12 months) assessments, effects of the CBSM on psychological, physiological and clinical out-come variables in HIV-infected patients under HAART will be evaluated. Additionally, the effects of CBSM on the neuroendocrine and autonomic stress reactivity in HIV-infected patients will be assessed, thus evaluating a possible direct pathway between emotional distress and physiological HIV-relevant parameters. In conclusion, the planned research project evaluates the effectiveness of a standardized psychosocial intervention as a possible component of a comprehensive disease management in HIV-infected patients under HAART.

Study Overview

• Status: Completed
• Conditions: HIV Infections
• Intervention / Treatment: Behavioral: Cognitive behavioral stress management training

• Study Type: Interventional
• Enrollment: 100
• Phase: Phase 3

Contacts and Locations

Study Locations

• Switzerland
  • Zuerich, Switzerland, 8006
    • University Hospital Zurich

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adults between 18 and 65 years of age
• Sufficient German-speaking abilities to participate in group therapy
• cARTwithin the previous three months,
• CD4 lymphocyte count above 100 cells/mL

Exclusion Criteria:

• Active opportunistic infection at baseline
• Formal psychotherapy within the previous three months
• Intravenous drug users
• Diagnosable current major psychiatric disorder (bipolar affective disorder, psychotic disorders, major depression with melancholia) and diagnosis of antisocial and borderline personality disorders at baseline

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
CD4 cell count
HIV viral load

Secondary Outcome Measures

Outcome Measure
Depression and Anxiety
QUality of life

Collaborators and Investigators

• Sponsor: University of Zurich
• Collaborators: Swiss National Science Foundation
• Investigators: Principal Investigator: Jens Gaab, PhD, Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich; Principal Investigator: Rainer Weber, MD, University Hospital, Zürich; Principal Investigator: Ulrike Ehlert, PhD, Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich

Study record dates

Study Major Dates

• Study Start: December 1, 2003
• Study Completion: December 1, 2005

Study Registration Dates

• First Submitted: February 15, 2007
• First Submitted That Met QC Criteria: February 15, 2007
• First Posted (Estimate): February 16, 2007

Study Record Updates

• Last Update Posted (Estimate): February 16, 2007
• Last Update Submitted That Met QC Criteria: February 15, 2007
• Last Verified: February 1, 2007

More Information

Terms related to this study

• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases; HIV Infections; Infections; Acquired Immunodeficiency Syndrome
• Other Study ID Numbers: 3346C0-100907