PST in Geriatric Depression with Executive Dysfunction

PST 治疗伴有执行功能障碍的老年抑郁症

基本信息

批准号：
7099631
负责人：
Patricia A. Arean
金额：
$ 36.98万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-20 至 2008-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7099631
关键词：
antidepressants audiotape behavior prediction behavioral /social science research tag clinical research cognition disorders decision making functional ability geriatrics human old age (65+)human subject human therapy evaluation interview major depression patient oriented research problem solving psychological aspect of aging psychotherapy

项目摘要

DESCRIPTION (provided by applicant): This study proposes to compare the efficacy of Problem Solving Therapy (PST) to that of Supportive Therapy (ST) in non-demented elderly patients with major depression and cognitive impairment. Among them, we will focus on patients with major depression and executive dysfunction because this combination of symptoms (as defined in our preliminary studies) is prevalent, debilitating, and responds poorly to treatment with antidepressant agents. Therefore, we find it compelling to identify an effective treatment for these patients, who would otherwise remain depressed, debilitated, and demoralized during the last years of their lives. We selected PST because it can address depression as well as deficits in problem solving skills that impact on the patients' ability to negotiate their environment and contribute to their depression and disability. Moreover we now have empirical evidence suggesting that PST can reduce depressive symptoms and disability in cognitively unimpaired depressed elderly patients as well as elderly patients with major depression and executive dysfunction. The subjects will be 240 (120 from each Center) elderly (>64 years) patients with non-psychotic, unipolar major depression and executive dysfunction and will be randomly assigned to receive 12 sessions of PST or ST. The study is designed to test the hypotheses that the PST is more effective than ST in reducing depressive symptoms and disability. Furthermore, we hypothesize that these effects are mediated by improvement in generation of alternative solutions, decision making, and solution implementation. While we are aware of the methodological problems and confounds posed by studying a "sick and old population", we bring to this project two groups with complementary expertise in treatment studies and psychotherapy research, and experience in directing multicenter studies. Moreover, the project will be supported by the structures of the Cornell Intervention Research Center (IRC), whose principal objective is to develop treatment interventions targeting specific clinical and biological characteristics of geriatric depression. Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research.

描述（由申请人提供）：本研究建议将问题解决疗法（PST）与支持性疗法（ST）的功效进行比较，对非痴呆的重度抑郁症和认知障碍患者的疗效。其中，我们将重点关注重度抑郁症和执行功能障碍的患者，因为这种症状的组合（如我们的初步研究中所定义）是普遍，使人衰弱，并且对用抗抑郁药的治疗做出了很大的反应。因此，我们发现为这些患者确定有效治疗是令人信服的，这些患者在生命的最后几年中会保持沮丧，衰弱和沮丧。我们之所以选择PST，是因为它可以解决抑郁症以及解决问题技能的缺陷，这些技能影响了患者谈判环境并有助于抑郁和残疾的能力。此外，我们现在有经验证据表明，PST可以减少认知未受损的老年患者以及重度抑郁症和执行功能障碍的老年患者的抑郁症状和残疾。受试者将为240名（每个中心120个）老年人（> 64岁）患有非精神病，单极重大抑郁症和执行功能障碍的患者，并将随机分配以接受12次PST或ST课程。该研究旨在检验PST在减轻抑郁症状和残疾方面比ST更有效的假设。此外，我们假设这些影响是通过改善替代解决方案，决策和解决方案实施的改善来介导的。虽然我们意识到通过研究“病人和老年人群”所带来的方法论问题和混淆，但我们将两个群体带入了在治疗研究和心理治疗研究方面具有互补专业知识的两个小组，并在指导多中心研究方面经验。此外，该项目将得到康奈尔干预研究中心（IRC）的结构的支持，其主要目的是制定针对老年抑郁症的特定临床和生物学特征的治疗干预措施。因此，我们在这一困难但重要的研究领域所固有的挑战处于良好状态。

项目成果

期刊论文数量（9）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Do manualized treatments for depression reduce insomnia symptoms?

抑郁症的手动治疗可以减轻失眠症状吗？

DOI：
10.1002/jclp.22062
发表时间：
2014
期刊：
Journal of clinical psychology
影响因子：
3
作者：
Yon,Adriana;Scogin,Forrest;DiNapoli,ElizabethA;McPherron,Jesse;Arean,PatriciaA;Bowman,Daniel;Jamison,ChristineS;Karpe,JenniferA;Latour,David;Reynolds3rd,CharlesF;Rohen,Noelle;Pardini,JamieEL;Thompson,LarryW
通讯作者：
Thompson,LarryW

The sensitivity and specificity of cognitive screening instruments to detect cognitive impairment in older adults with severe psychiatric illness.