| Preventing late-life depression in age-related macular degeneration. | |
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MedLine Citation:
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PMID: 18515689 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether problem-solving treatment (PST) can prevent depressive disorders in patients with age-related macular degeneration (AMD). DESIGN: Two hundred six patients with AMD were randomly assigned to PST (n = 105) or usual care (n = 101). PST therapists delivered six PST sessions over 8 weeks in subjects' homes. MEASUREMENTS: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition Diagnoses of Depressive Disorders, Hamilton Depression Rating Scale scores, and rates of relinquishing valued activities were assessed at 2 months for short-term effects and 6 months for maintenance effects. RESULTS: The 2-month incidence rate of depressive disorders in PST-treated subjects was significantly lower than controls (11.6% versus 23.2%, respectively; OR = 0.43; 95% CI [0.20, 0.95]). PST also reduced the odds of relinquishing a valued activity (OR = 0.48; 95% CI [0.25, 0.96]); this effect mediated the relationship between treatment group and depression. By 6 months most earlier observed benefits had diminished. Secondary analyses showed that a minimal level of depressive symptoms were disabling and predicted incident depressive disorders. CONCLUSION: PST prevented depressive disorders and loss of valued activities as a short-term treatment but these benefits were not maintained over time. To sustain PST's effect, an intervention that uses a problem-solving framework to enhance rehabilitative skills may be necessary. |
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Authors:
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Barry W Rovner; Robin J Casten |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry Volume: 16 ISSN: 1545-7214 ISO Abbreviation: Am J Geriatr Psychiatry Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-02 Completed Date: 2008-08-07 Revised Date: 2013-04-18 |
Medline Journal Info:
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Nlm Unique ID: 9309609 Medline TA: Am J Geriatr Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 454-9 Citation Subset: IM |
Affiliation:
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Department of Psychiatry and Neurology, Jefferson Medical College, Jefferson Medical College, Philadelphia, PA 19107, USA. barry.rovner@jefferson.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Activities of Daily Living
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psychology Aged Behavior Therapy / methods* Depressive Disorder / diagnosis, prevention & control*, psychology Depressive Disorder, Major / diagnosis, prevention & control, psychology Female Follow-Up Studies Goals Humans Macular Degeneration / psychology*, rehabilitation Male Middle Aged Problem Solving* Psychotherapy, Brief / methods* Risk Factors Sick Role |
| Grant Support | |
ID/Acronym/Agency:
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R0 1 MH61331/MH/NIMH NIH HHS; R01 MH061331/MH/NIMH NIH HHS; U01 EY 015839/EY/NEI NIH HHS; U01 EY015839/EY/NEI NIH HHS |
| Comments/Corrections | |
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