Effectiveness of problem-solving therapy for older, primary care patients with depression: results from the IMPACT project.

Full Abstract

PURPOSE:
We compared a primary-care-based psychotherapy, that is, problem-solving therapy for primary care (PST-PC), to community-based psychotherapy in treating late-life major depression and dysthymia.

DESIGN AND METHODS:
The data here are from the IMPACT study, which compared collaborative care within a primary care clinic to care as usual in the treatment of 1,801 primary care patients, 60 years of age or older, with major depression or dysthymia. This study is a secondary data analysis (n = 433) of participants who received either PST-PC (by means of collaborative care) or community-based psychotherapy (by means of usual care).

RESULTS:
Older adults who received PST-PC had more depression-free days at both 12 and between 12 and 24 months (beta = 47.5, p <.001; beta = 47.0, p <.001), and they had fewer depressive symptoms and better functioning at 12 months (beta(dep) = -0.36, p <.001; beta(func) = -0.94, p <.001), than those who received community-based psychotherapy. We found no differences at 24 months.

IMPLICATIONS:
Results suggest that PST-PC as delivered in primary care settings is an effective method for treating late-life depression.

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Author information

Author/s: Arean, Patricia (P); Hegel, Mark (M); Vannoy, Steven (S); Fan, Ming-Yu (MY); Unuzter, Jurgen (J);

Affiliation: University of California San Francisco, Department of Psychiatry, San Francisco, CA 94143, USA. pata(-atsign-)lppi.ucsf.edu

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: The Gerontologist (Gerontologist), published in United States. (Language: eng)

Reference: 2008-Jun; vol 48 (issue 3) : pp 311-23

Dates: Created 2008/07/01; Completed 2008/09/02;

PMID: 18591356, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Depression - psychology; therapy
Educational Status
Family Practice - methods
Female
Follow-Up Studies
Humans

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