Thursday, April 17, 2014

Problem-Solving Therapy May Help Prevent Onset of Major Depression In Elderly, Study Finds


According to a study published in Psychiatric Services, problem-solving therapy for primary care (PST-PC)—an intervention delivered by nonmental health professionals to help patients improve coping skills and confidence—may serve as a beneficial therapy for older adults who are at risk for major depression.

Charles Reynolds III, M.D., a professor of geriatric psychiatry at the University of Pittsburgh Medical Center, and colleagues evaluated the efficacy of PST-PC in preventing episodes of major depression and reducing depressive symptoms in elderly adults. The study, "Early Intervention to Preempt Major Depression Among Older Black and White Adults," included approximately 250 individuals with subsyndromal depressive symptoms who received 15 months of PST-PC, a technique that has been shown to reduce stress, or dietary coaching, which had been shown to reduce depression risk in an elderly population in a previous study by Reynolds. The two cohorts were compared with each other, in addition to being compared with age-matched cohorts from previously published studies of those who received neither therapy for subsyndromal depressive symptoms.

After two years, the analysis showed PST-SC to be just as effective as dietary coaching in preventing episodes of major depression in this at-risk cohort. Incident rates for major depression in both cohorts were approximately 9%, compared with published rates of 20% to 25% in those who received neither treatment. The researchers also observed a significant reduction in depressive symptoms in both PST-SC and dietary-coaching groups.

“Avoiding episodes of major depression can help people stay happy and engaged in their communities...," commented Reynolds. “This project tells us that interventions in which people actively engage in managing their own life problems...tend to have a positive effect on well-being and a protective effect against the onset of depression.”

To read more about the role of problem-solving therapy in treating mental illness, see the Psychiatric News article, "Future Looks Promising for Mental Illness Prevention."

(Photo Courtesy of PUMC)

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