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Problem-solving therapy for late-life depression in home care: a randomized field trial
Zvi D Gellis1, Jean McGinty, Amy Horowitz
1Center for Mental Health and Aging, School of Social Welfare, State University of New York, Albany, NY 12222, USA. gellis@albany.edu
Summary
Brief Problem-Solving Therapy in Home Care (PST-HC) significantly improved depression, quality of life, and problem-solving skills in older adults. This pilot study shows PST-HC is a promising intervention for late-life depression in home care settings.
Area of Science:
- Gerontology
- Psychiatry
- Home Healthcare
Background:
- Older adults in home care settings often experience severe depressive symptoms.
- Effective interventions are needed to address late-life depression within the home care context.
Purpose of the Study:
- To develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC).
- To evaluate the efficacy of PST-HC for older adults with severe depressive symptoms in an acute home care setting.
Main Methods:
- A pilot randomized clinical trial compared PST-HC to usual care (UC).
- Forty medically ill home care patients with severe depressive symptoms were randomized.
- Intervention involved six weekly home-based PST-HC sessions.
- Outcomes (depression, quality of life, problem-solving) were assessed at baseline, post-treatment, and 3- and 6-month follow-ups by blinded evaluators.
Main Results:
- All 40 participants completed follow-up; no demographic differences between groups.
- PST-HC demonstrated significant improvements in depression scores over time compared to UC.
- PST-HC patients reported higher quality of life and enhanced problem-solving abilities relative to UC.
Conclusions:
- PST-HC is well-tolerated and shows potential for reducing persistent depressive symptoms in older adults.
- The study highlights the promise of PST-HC as a psychosocial treatment for late-life depression.
- Limitations regarding real-world applicability are discussed.
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