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Randomized Trial of Cognitive Behavior Therapy Versus Supportive Psychotherapy for HIV-Related Peripheral Neuropathic Pain

Received Feb. 15, 2002; revision received May 7, 2002; accepted May 22, 2002. From the Department of Psychiatry, Weill Medical College of Cornell University, New York. Address reprint requests to Dr. Evans, 425 E. 61st St., Suite 1350, New York, NY 10021; sue2002{at}med.cornell.edu (e-mail).

The feasibility and acceptability of cognitive behavior therapy for HIV-related peripheral neuropathic pain was examined and the potential efficacy of the intervention was compared with that of supportive psychotherapy in reducing pain, pain-related interference with functioning, and distress. Sixty-one patients were randomly assigned to receive six weekly sessions of cognitive behavior therapy or supportive psychotherapy. Thirty-three subjects completed the protocol. Both groups showed significant reductions in pain. The cognitive behavior group improved in most domains of pain-related functional interference and distress; the supportive psychotherapy group showed fewer gains. The high dropout rate suggests that psychotherapeutic treatments for HIV-related pain may have limited feasibility and acceptability.

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