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

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.