Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
George S AlexopoulosPatricia A Areán

Abstract

To test the hypotheses that (1) clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in reducing depressive symptoms of depressed, disabled, impoverished patients and that (2) development of problem-solving skills mediates improvement of depression. This randomized clinical trial with a parallel design allocated participants to CM or CM-PST at 1:1 ratio. Raters were blind to patients' assignments. Two hundred seventy-one individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST. Participants were at least 60 years old with major depression measured with the 24-item Hamilton Depression Rating Scale (HAM-D), had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties' median. CM and CM-PST led to similar declines in HAM-D over 12 weeks (t = 0.37, df = 547, p = 0.71); CM was noninferior to CM-PST. The entire study group (CM plus CM-PST) had a 9.6-point decline in HAM-D (t = 18.7, df = 547, p <0.0001). The response (42.5% versus 33.3%) and remission (37.9% versus 31.0%) rates were similar (χ(2) = 1.5, df = 1, p = 0.22 and χ(2) = 0.9, df = 1, p = 0.34, re...Continue Reading

References

Jan 1, 1982·Journal of Gerontology·M P LawtonM H Kleban
Jul 27, 2000·The British Journal of Psychiatry : the Journal of Mental Science·T ReynoldsM Orrell
Sep 1, 2001·International Journal of Psychiatry in Medicine·P A Areán, J Alvidrez
Oct 27, 2001·BMJ : British Medical Journal·J Epping-JordanE Sabaté
Aug 3, 2002·The American Journal of Psychiatry·Martha L BruceCarol Weber
Oct 23, 2002·Archives of Disease in Childhood·L Diggle, J Deeks
Jan 16, 2003·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·George S AlexopoulosPatricia Areán
Jul 31, 2003·Journal of Psychiatric and Mental Health Nursing·A SimpsonL Bowers
Feb 1, 1960·Journal of Neurology, Neurosurgery, and Psychiatry·M HAMILTON
Jan 4, 2006·Archives of General Psychiatry·Alex CohenCharles F Reynolds
Jan 20, 2006·Psychology and Aging·Patricia A AreánLarry Thompson
Sep 17, 2009·Annals of Internal Medicine·Jochen GensichenUNKNOWN PRoMPT (PRimary care Monitoring for depressive Patients Trial)
Jun 3, 2010·The American Journal of Psychiatry·Patricia A AreánGeorge S Alexopoulos
Jun 4, 2014·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Edward ChesneySeena Fazel

❮ Previous
Next ❯

Citations

Jan 9, 2016·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Helen Lavretsky
Nov 9, 2016·Disability and Rehabilitation·Stefano FedericiJuan V Luciano
Jul 21, 2017·Current Psychiatry Reports·Patrick J RaueJo Anne Sirey
Aug 7, 2019·Translational Psychiatry·George S Alexopoulos
Sep 22, 2017·Current Treatment Options in Psychiatry·Brenna N Renn, Patricia A Areán
Jan 15, 2018·European Psychiatry : the Journal of the Association of European Psychiatrists·Pim CuijpersDavid D Ebert
Feb 24, 2019·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Steven M AlbertCharles F Reynolds Iii

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.