Problem-solving therapy for late-life depression in home care: a randomized field trial

Am J Geriatr Psychiatry. 2007 Nov;15(11):968-78. doi: 10.1097/JGP.0b013e3180cc2bd7. Epub 2007 Sep 10.

Abstract

Objective: The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC) that targets the needs of older adults identified with severe depressive symptoms in an acute home care setting.

Methods: A pilot randomized clinical trial compared the impact of PST-HC to usual care (UC) in a sample of older medically ill home care patients identified with severe depressive symptoms. Forty patients were randomly assigned to either six weekly sessions of PST-HC in their home or standard home care services. Depression, quality of life, and problem-solving ability were measured at baseline, posttreatment, three-month follow-up, and six-month follow-up by blinded evaluators.

Results: All 40 patients provided follow-up data. No differences between the two groups were found on any demographic variables. Outcome data suggested significant improvements in depression scores over time after PST-HC, relative to UC. PST-HC patients reported higher quality of life and problem-solving ability scores relative to UC.

Conclusion: Results suggest that PST-HC is well tolerated and holds promise for reducing persistent depressive symptoms. The authors discuss limitations in terms of the "real-world" applicability of this psychosocial treatment for late-life depression.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy*
  • Educational Status
  • Female
  • Health Status
  • Home Care Services* / standards
  • Humans
  • Male
  • Personal Satisfaction
  • Pilot Projects
  • Problem Solving*
  • Psychiatric Status Rating Scales
  • Psychotherapy / methods*
  • Psychotherapy / standards
  • Treatment Outcome