Longitudinal assessment of psychotherapeutic day hospital treatment for elderly patients with depression.
OBJECTIVE
Although previous studies suggested that psychiatric day hospital care is a valuable alternative to inpatient treatment, its effectiveness for elderly patients is disputed. Small number of cases, poor definition of the psychotherapeutic setting, and absence of systematic assessment at different time points may explain the observed discrepancies. We performed an assessment of a psychiatric day hospital treatment combining individual and group psychotherapy in a series of 122 elderly depressed outpatients.


METHODS
The Geriatric Depression Scale, Short Form Survey, as well as a Therapeutic Community Assessment Scale and Group Evaluation Scale were repeated at admission, 3, 6, 12 months and discharge. The day hospital program was based on psychotherapeutic treatment combining individual and group settings. All patients presented with major depression or a depressive episode of bipolar disease. Variables included severity of depressive symptoms, quality of life, adhesion to therapeutic community treatment and progress in groups of psychotherapy, art-therapy, and psychomotricity.


RESULTS
There was a significant reduction of depressive symptoms, and improvement in mental quality of life across all time points studied. Adhesion to therapeutic community increased from admission to discharge. This was also the case for the progress in group therapy for all three groups used, yet the evolution of this parameter at intermediate time points was highly variable. Neither demographic characteristics, nor pharmacological treatment or presence of stressful life events predicted the clinical improvement.


CONCLUSIONS
Psychotherapeutic care program in day hospitals may improve clinical status and quality of life in elderly depressed patients.
Canuto
Alessandra
A
Division of Geriatric Psychiatry, University Hospitals of Geneva, Geneva, Switzerland. alessandra.canuto@hcuge.ch
Meiler-Mititelu
Corina
C
Herrmann
François R
FR
Delaloye
Christophe
C
Giannakopoulos
Panteleimon
P
Weber
Kerstin
K
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003631:Day Care, Medical; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods* / Q000592:standards; D011615:Psychotherapy, Group; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life
D011619:Psychotropic Drugs