Dialectical behavior therapy for depressed older adults: a randomized pilot study.
OBJECTIVE
Although there is evidence for the efficacy of antidepressants and for some individual and group psychotherapy interventions for depressed older adults, a significant number of these do not respond to treatment. Authors assessed the benefits of augmenting medication with group psychotherapy.


METHODS
They randomly assigned 34 (largely chronically) depressed individuals age 60 and older to receive 28 weeks of antidepressant medication plus clinical management, either alone (MED) or with the addition of dialectical behavior therapy skills-training and scheduled telephone coaching sessions (MED+DBT).


RESULTS
Only MED+DBT showed significant decreases on mean self-rated depression scores, and both treatment groups demonstrated significant and roughly equivalent decreases on interviewer-rated depression scores. However, on interviewer-rated depression, 71% of MED+DBT patients were in remission at post-treatment, in contrast to 47% of MED patients. At a 6-month follow-up, 75% of MED+DBT patients were in remission, compared with only 31% of MED patients, a significant difference. Only patients receiving MED+DBT showed significant improvements from pre- to post-treatment on dependency and adaptive coping that are proposed to create vulnerability to depression.


CONCLUSIONS
Results from this pilot study suggest that DBT skills training and telephone coaching may offer promise to effectively augment the effects of antidepressant medication in depressed older adults.
Lynch
Thomas R
TR
Duke University Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27704, USA. lynch011@mc.duke.edu
Morse
Jennifer Q
JQ
Mendelson
Tamar
T
Robins
Clive J
CJ
D000223:Adaptation, Psychological; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D002908:Chronic Disease; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011615:Psychotherapy, Group / Q000379:methods