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Using problem solving therapy to treat veterans with subsyndromal depression: a pilot study.

J Kasckow1, J Klaus, J Morse

  • 1VA Pittsburgh Behavioral Health, VISN 4 CHERP and VISN 4 MIRECC, University Dr, Pittsburgh, PA, USA; UPMC Western Psychiatric Institute and Clinics, Pittsburgh, PA, USA.

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Problem Solving Therapy for Primary Care (PST-PC) showed potential in improving mental health functioning for veterans with subsyndromal depression. This pilot study suggests PST-PC may be a beneficial intervention for this population.

Keywords:
depressionmental health functioningproblem solving therapyveteran

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Area of Science:

  • Geriatric Medicine
  • Mental Health Research
  • Primary Care Interventions

Background:

  • Subsyndromal depression and emotional distress are prevalent in middle-aged and older veterans.
  • Primary care settings are crucial for identifying and managing mental health conditions in veteran populations.
  • Existing interventions may not fully address the unique needs of veterans with subsyndromal depression.

Purpose of the Study:

  • To compare the efficacy of Problem Solving Therapy for Primary Care (PST-PC) against a dietary education control in veterans aged 50 and older.
  • To evaluate the impact of PST-PC on depressive symptoms, mental health functioning, and social problem-solving skills.
  • To assess the feasibility of a brief, primary care-based intervention for subsyndromal depression in a veteran cohort.

Main Methods:

  • A pilot, two-site randomized controlled trial involving veterans over 50 with elevated depressive symptoms (CES-D score >11).
  • Participants were randomized to either Problem Solving Therapy for Primary Care (PST-PC) or a dietary education (DIET) control group.
  • Interventions consisted of six to eight sessions over a 4-month period, with outcomes assessed at the end of treatment.

Main Results:

  • Significant improvements were observed in SF-36 mental health component scores for the PST-PC group compared to the DIET group.
  • No significant differences were found between groups in depressive symptoms (Hamilton Rating Scale, Beck Depression Inventory), social problem-solving skills, or physical health.
  • Treatment completion rates were 51% (11/23 in PST-PC, 12/22 in DIET).

Conclusions:

  • A brief, six-to-eight session version of PST-PC may enhance mental health functioning in primary care veterans experiencing subsyndromal depressive symptoms.
  • PST-PC shows promise as a targeted intervention for improving mental well-being in this specific veteran population.
  • Further research is warranted to confirm these findings in larger, more diverse veteran samples.