title: Treatment of depressive symptoms in diverse, rural, and vulnerable older adults.
abstract: BACKGROUND
  We examined the effects of home-delivered cognitive-behavior therapy (CBT) on depressive symptoms among rural, diverse, and vulnerable older adults. Furthermore, we differentiated depression into its two salient aspects: psychological and somatic.
  
  
  METHODS
  Data came from a randomized controlled experiment of CBT on 134 individuals residing in rural Alabama.
  
  
  RESULTS
  Cognitive-behavior therapy resulted in significantly lower depressive symptom severity scores. When depressive symptoms were categorized as psychological or somatic, CBT was found to significantly improve the former but not the latter. Notably, there was a trend toward somatic symptom improvement.
  
  
  CONCLUSIONS
  Cognitive-behavior therapy can be an effective treatment for depression in a hard-to-reach group of older adults. Home delivery affords advantages but is also an expensive delivery modality. Diverse older adults responded to the CBT intervention.
authors.affiliation: The University of Alabama, Department of Psychology, Tuscaloosa, AL, USA.
authors.forename: Forrest R
authors.initials: FR
authors.lastname: Scogin
authors.forename: Kathryn
authors.initials: K
authors.lastname: Moss
authors.forename: Grant M
authors.initials: GM
authors.lastname: Harris
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Presnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000458:organization & administration; D003866:Depressive Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration; D006699:Home Care Services / Q000191:economics / Q000592:standards; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration*; D012424:Rural Population; D035862:Vulnerable Populations
keywords: CBT; depression; diversity; rural
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