The prevention of depression in nursing home residents: A randomized clinical trial of cognitive-behavioral therapy

Authors: Konnert, Candace1; Dobson, Keith1; Stelmach, Liza2

Source: Aging and Mental Health, Volume 13, Number 2, March 2009 , pp. 288-299(12)

Publisher: Routledge, part of the Taylor & Francis Group

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Abstract:

The prevention of depression in individuals who are at risk is important for affected individuals, their family members, and for society at large. This study presents the results of a randomized clinical trial aimed at the prevention of depression in nursing home residents. Residents were screened with the Geriatric Depression Scale (GDS) and a diagnostic interview. Those with elevated GDS scores who did not meet diagnostic criteria for depression were randomly assigned to a treatment or control (treatment as usual, TAU) condition. The treatment was an adaptation of the Coping with Stress program developed by Clarke et al. (1995; Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312-321), and focused on various components typical of cognitive-behavioral treatment (CBT) programs (e.g. increasing pleasant events, reducing negative cognitions). Both groups were assessed on measures of depression before treatment, after treatment, and at 3- and 6-month follow-up points. Compared with the TAU group, residents receiving the intervention showed considerable improvement over the 6-month follow-up on the GDS. Average scores on the GDS, for example, went from 14.0 to 9.4 in the CBT group over the course of treatment and follow-up, vs. scores from 13.4 to 12.3 for the TAU group over the same time. However, results on the Center for Epidemiological Studies Depression Scale at 3 months were nonsignificant. Overall, the results of this study suggest that a brief, group-based CBT program can have significant benefit in nursing home residents at risk for depression.

Keywords: subsyndromal depression; long-term care; prevention

Document Type: Research article

DOI: 10.1080/13607860802380672

Affiliations: 1: Psychology, University of Calgary, Calgary, Alberta, Canada 2: Carewest Dr Vernon Fanning Centre, Calgary, Alberta, Canada

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