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Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction
Patricia A Areán1, Patrick Raue, R Scott Mackin
1Department of Psychiatry, University of California, San Francisco, CA 94143, USA. pata@lppi.ucsf.edu
The American Journal of Psychiatry
|June 3, 2010
Summary
Problem-solving therapy effectively reduced depressive symptoms in older adults with major depression and executive dysfunction. This therapy offers a valuable alternative for patients resistant to standard antidepressant drugs.
Area of Science:
- Geriatric Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Older adults with depression often exhibit executive dysfunction.
- This population may show resistance to traditional antidepressant pharmacotherapy.
Purpose of the Study:
- To evaluate the efficacy of problem-solving therapy (PST) in older adults (60+) with major depression and executive dysfunction.
- To assess PST as a potential treatment alternative for this patient group.
Main Methods:
- A randomized controlled trial comparing modified PST to supportive therapy.
- Participants (N=221) received 12 weekly sessions.
- Assessments conducted at weeks 3, 6, 9, and 12.
Main Results:
- Problem-solving therapy showed greater reductions in depressive symptom severity at weeks 9 and 12 compared to supportive therapy.
- Higher response and remission rates were observed in the PST group at weeks 9 and 12.
- PST achieved one additional response or remission for every 4.4-5.6 patients by trial end.
Conclusions:
- Problem-solving therapy is effective for reducing depressive symptoms, response, and remission in older adults with major depression and executive dysfunction.
- PST presents a viable treatment option for older patients with depression who are resistant to pharmacotherapy.
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