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Problem-Solving Therapy in the Elderly.

Dimitris N Kiosses1, George S Alexopoulos1

  • 1Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College.

Current Treatment Options in Psychiatry
|April 15, 2014
PubMed
Summary
This summary is machine-generated.

Problem-solving therapy (PST) effectively reduces depressive symptoms in older adults compared to other therapies. It also shows promise in improving quality of life and reducing disability across various conditions, including macular degeneration and after stroke.

Keywords:
Geriatric psychiatryLate-life depressionOlder adultsPreventionProblem-solving therapyQuality of lifeTreatment

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Area of Science:

  • Gerontology
  • Psychiatry
  • Clinical Psychology

Background:

  • Late-life depression presents significant challenges.
  • Problem-solving therapy (PST) is a potential intervention for older adults.
  • Evidence for PST's efficacy across diverse geriatric populations is needed.

Purpose of the Study:

  • To systematically review randomized clinical trials on Problem-solving therapy (PST) in older adults.
  • To evaluate PST's effectiveness in reducing depressive symptoms and disability.
  • To assess PST's impact on various conditions including major depression, minor depression, dysthymia, and conditions like macular degeneration and stroke.

Main Methods:

  • Systematic review of randomized clinical trials (RCTs).
  • Comparison of PST against supportive therapy (ST), reminiscence therapy, paroxetine, placebo, and usual care.
  • Analysis of outcomes including depressive symptoms, disability, quality of life, and incidence of depression and apathy.

Main Results:

  • PST significantly reduced depressive symptoms in late-life major depression compared to ST and reminiscence therapy.
  • PST showed comparable reductions in depression to paroxetine and placebo for minor depression and dysthymia.
  • PST improved disability and quality of life in patients with executive dysfunction, macular degeneration, and reduced depression incidence in stroke patients.

Conclusions:

  • Problem-solving therapy (PST) is an effective intervention for reducing depressive symptoms and disability in various older adult populations.
  • PST demonstrates efficacy across different delivery methods, including in-person, phone, internet, and videophone.
  • Adaptations to PST, such as caregiver involvement and environmental modifications, enhance its utility for individuals with cognitive impairment.