title: Specialist mental health consultation for depression in Australian aged care residents with dementia: a cluster randomized trial.
abstract: OBJECTIVE
  This cluster randomized controlled trial sought to determine whether multidisciplinary specialist mental health consultation was more effective than care as usual in treating the depression of aged care residents with dementia.
  
  
  METHODS
  Three hundred and eighty nine aged care residents were screened for dementia and major depression. Forty four were ultimately included in the intervention sample, selected from 20 aged care facilities located in Melbourne, Australia. Facilities were randomly allocated to an intervention condition involving the provision of multidisciplinary specialist consultation regarding the best-practice management of depression in dementia, or to a care as usual condition. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and general practitioners. All residents participated in a comprehensive pre-intervention diagnostic assessment, including the administration of the Cornell Scale for Depression in Dementia. This assessment was repeated approximately 15 weeks post-intervention by a rater blind to study condition.
  
  
  RESULTS
  Multidisciplinary specialist mental health consultation was significantly more effective than care as usual in treating the clinical depression of aged care residents with dementia (p < 0.05, partial η(2)  = 0.16). At follow-up, the mean Cornell Scale for Depression in Dementia score for the intervention group was 9.47, compared with 14.23 for the control group. In addition, 77% of the intervention group no longer met criteria for major depression.
  
  
  CONCLUSIONS
  The results of this study suggest that the psychosocial and medical management of depressed aged care residents can be improved by increasing access to specialist mental health consultation.
authors.affiliation: Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia. kate.mcsweeney@monash.edu
authors.forename: Kate
authors.initials: K
authors.lastname: McSweeney
authors.forename: Aimee
authors.initials: A
authors.lastname: Jeffreys
authors.forename: Joanne
authors.initials: J
authors.lastname: Griffith
authors.forename: Chris
authors.initials: C
authors.lastname: Plakiotis
authors.forename: Renee
authors.initials: R
authors.lastname: Kharsas
authors.forename: Daniel W
authors.initials: DW
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001315:Australia; D003704:Dementia / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D009735:Nursing Homes / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation / Q000592:standards*; D013038:Specialization