Problem-solving therapy versus supportive therapy in geriatric major depression with executive dysfunction.

Full Abstract

OBJECTIVE:
The authors compared the efficacy of problem-solving therapy (PST) and supportive therapy (ST) in a group of elderly subjects with impairment in executive functions. This group was targeted because it has been shown to be at the risk for poor response to pharmacotherapy.

METHODS:
A total of 25 elderly subjects with major depression and abnormal scores in initiation/perseveration and response inhibition tasks were randomly assigned to receive weekly sessions of PST or ST for 12 weeks. The subjects were systematically evaluated by raters blind to the study hypotheses.

RESULTS:
PST was more effective than ST in leading to remission of depression, fewer post-treatment depressive symptoms, and less disability. A substantial part of the change in depression and disability was explained by the subjects' improvement of skills in generating alternatives and in decision-making.

CONCLUSION:
This preliminary study suggests that PST is effective in reducing depressive symptoms and disability in elderly patients with major depression and executive dysfunction. If these findings are confirmed, PST may become an important therapeutic alternative for a patient population who may otherwise remain symptomatic and disabled.

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Author information

Author/s: Alexopoulos, George S (GS); Raue, Patrick (P); Areán, Patricia (P);

Affiliation: Cornell Institute of Geriatric Psychiatry, White Plains, NY 10605, USA.

Grants: P30 MH49762 (Agency:United States NIMH) ; R01 MH42819 (Agency:United States NIMH) ; R01 MH51842 (Agency:United States NIMH) ; T32 MH19132 (Agency:United States NIMH)

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (Am J Geriatr Psychiatry), published in United States. (Language: eng)

Reference: -2003 Jan-Feb; vol 11 (issue 1) : pp 46-52

Dates: Created 2003/01/15; Completed 2003/04/23; Revised 2007/11/14;

PMID: 12527539, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Aged, 80 and over
Cognitive Therapy - methods
Depressive Disorder, Major - psychology; therapy
Disability Evaluation
Female

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