Problem-solving therapy for late-life depression in home care: a randomized field trial.
OBJECTIVE
The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of Brief Problem-Solving Therapy in Home Care (PST-HC) that targets the needs of older adults identified with severe depressive symptoms in an acute home care setting.


METHODS
A pilot randomized clinical trial compared the impact of PST-HC to usual care (UC) in a sample of older medically ill home care patients identified with severe depressive symptoms. Forty patients were randomly assigned to either six weekly sessions of PST-HC in their home or standard home care services. Depression, quality of life, and problem-solving ability were measured at baseline, posttreatment, three-month follow-up, and six-month follow-up by blinded evaluators.


RESULTS
All 40 patients provided follow-up data. No differences between the two groups were found on any demographic variables. Outcome data suggested significant improvements in depression scores over time after PST-HC, relative to UC. PST-HC patients reported higher quality of life and problem-solving ability scores relative to UC.


CONCLUSIONS
Results suggest that PST-HC is well tolerated and holds promise for reducing persistent depressive symptoms. The authors discuss limitations in terms of the "real-world" applicability of this psychosocial treatment for late-life depression.
Gellis
Zvi D
ZD
Center for Mental Health and Aging, School of Social Welfare, State University of New York, Albany, NY 12222, USA. gellis@albany.edu
McGinty
Jean
J
Horowitz
Amy
A
Bruce
Martha L
ML
Misener
Elizabeth
E
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006699:Home Care Services / Q000592:standards; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D010865:Pilot Projects; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome