title: Addressing depression in a long-term care setting: a phase II pilot of problem-solving treatment.
abstract: OBJECTIVE
  This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depression in residents of long-term care facilities. Our goal was to demonstrate PST implementation feasibility and to identify PST's potential for reducing depressive symptoms in this geriatric health care setting.
  
  
  METHODS
  Eligible participants were randomized to receive a PST treatment (six 1-hour sessions) or a social contact comparison (6 "friendly" visits) after an initial baseline assessment. Follow-up assessments occurred 7 weeks later (after treatment) and 2 months posttreatment. The basic analytic approach was based on an intention-to-treat analysis.
  
  
  RESULTS
  We enrolled 21 elderly subjects in the PST group and 16 elderly subjects in the social contact comparison group. The PST group experienced a decline in depression scores compared with the social contact group. Although not statistically significant (likely due to the small sample size), PST was associated with decreased depressive symptom scores for those who were able to complete the intervention. Implementation proved to be difficult in terms of study recruitment and intervention acceptance and adherence.
  
  
  CONCLUSIONS
  These study findings point to the potential benefits of an integrated mental health component in long-term care, involving rehabilitation professionals who are already working with the older adults in both postacute/short-stay and long-stay settings.
authors.affiliation: Jewish Home Lifecare, Research Institute on Aging, New York, New York; Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: jreinhardt@jewishhome.org.
authors.forename: Joann P
authors.initials: JP
authors.lastname: Reinhardt
authors.affiliation: Fordham University, Graduate School of Social Service, New York, New York.
authors.forename: Amy
authors.initials: A
authors.lastname: Horowitz
authors.affiliation: Jewish Home Lifecare, Research Institute on Aging, New York, New York.
authors.forename: Verena R
authors.initials: VR
authors.lastname: Cimarolli
authors.affiliation: Research Division, Hebrew Home at Riverdale, Riverdale, New York; Weill Cornell Medical Center, Division of Geriatrics and Palliative Care, New York, New York.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Eimicke
authors.affiliation: Research Division, Hebrew Home at Riverdale, Riverdale, New York; Columbia University Stroud Center, Faculty of Medicine and New York State Psychiatric Institute, New York, New York.
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Teresi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011340:Problem Solving; D012944:Social Support
keywords: long-term care; minor depression; problem-solving treatment; subsyndromal depression