To Activate or Not to Activate: An Integral Question for Self-Guided Behavioral Activation Interventions for Older Adults with Sub-Clinical Depression
| Autor: | Elliott R. Weinstein, Daniel E. Jimenez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Depressive Disorder
Major business.industry Depression Cost-Benefit Analysis Psychological intervention Behavioral activation Self guided Article United Kingdom Psychiatry and Mental health Behavior Therapy Sub clinical Quality of Life Medicine Humans Geriatrics and Gerontology business Depression (differential diagnoses) Clinical psychology Aged |
| Zdroj: | Am J Geriatr Psychiatry |
| Popis: | Treatment of established depression is the dominant approach to care of older adults, but prevention holds much promise. Self-help interventions are a feasible preventive approach, since they are scalable and low cost. There are few trials in this area. Behavioral Activation (BA) is a credible candidate psychological approach, which has been shown to work in therapist led care but not been trialled in a self-help form.To test the effectiveness of an unguided self-help intervention based on BA for older adults.We compared a self-help intervention based on BA for older people (n = 172) to usual care (n = 160) in a pragmatic randomized controlled trial. Outcomes were depression status and severity (PHQ9) and health related quality of life (SF12). The primary timepoint of the primary outcome was depression at 4 months, with longer term follow up at 12 months to test sustained impact of the primary outcome.At 4 months adjusted PHQ-9 scores for BA self-help were 0.79 lower (95% CI: -1.70 to 0.13; p = 0.09) and the proportion of participants with case-level depression was significantly reduced (BA 31/137 (22.6%) versus usual care 41/141 (29.1%); Odds Ratio 0.48; 95% CI: 0.26-0.92; p = 0.03). There was no PHQ-9 difference at 12 months or for health related quality of life at any point (4 or 12 months).Self-help using BA for older people at risk of depression is a feasible and scalable intervention with potential short-term benefits in preventing depression. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|