title: The effects of simultaneous exercise and psychotherapy on depressive symptoms in inpatient, psychiatric older adults.
abstract: BACKGROUND
  Depression is the leading cause of early death, affecting 15% of Americans older than 65 y and costing $43 billion each year. The current mental health service system for seniors, particularly for the population hospitalized in acute inpatient psychiatric units, is fragmented because of poor funding and a shift to a transitory health care paradigm, leading to inadequate treatment modalities, questionable quality of care, and lack of research demonstrating the superiority of a particular treatment. These issues are likely to lead to a public health crisis in the coming years.
  
  
  OBJECTIVE
  To investigate the effectiveness of combining exercise and psychotherapy in improving acute depressive symptoms among older adults who were receiving treatment in an inpatient psychiatric unit.
  
  
  METHODS
  Based on rolling admissions, inpatients were randomly assigned to 1 of 3 treatment groups. The study was blinded and controlled.
  
  
  METHODS
  This study took place in inpatient psychiatric units at the Loma Linda University's Behavioral Medicine Center (LLUBMC) in Redlands, California.
  
  
  METHODS
  Participants were 78 inpatients, aged 50-89 y.
  
  
  METHODS
  Participants in the simultaneous exercise and psychotherapy (STEP) group (n = 26) took part in exercise and received psychotherapy for 30 min per session, whereas those in the TALK group (n = 26) received individual psychotherapy for 30 min per session. Participants in the control group (n = 26) served as a comparison group, receiving standard therapy.
  
  
  METHODS
  The effects of the interventions were determined by assessing differences from baseline to postintervention in the symptomatology of all 3 groups. The research team also administered the Behavioral and Symptom Identification Scale (BASIS-32) and the Geriatric Depression Scale (GDS) pre- and postintervention.
  
  
  RESULTS
  At posttest, the STEP group (M = 4.24, SE = 0.62) had a better response than the TALK group (M = 11.34, SE = 0.62, P < .001), which in turn showed greater improvement than the control group (M = 14.84, SE = 0.62, P < .001). Overall, these results indicate that patients' posttreatment depression scores were significantly lower in those receiving the STEP treatment compared with those receiving individual psychotherapy only or standard care.
  
  
  CONCLUSIONS
  A short-term exercise program consisting of 30 min of walking in conjunction with individual psychotherapy was an effective intervention for depression among older adults in inpatient psychiatric units.
authors.forename: Son D
authors.initials: SD
authors.lastname: Jacquart
authors.forename: Helen H
authors.initials: HH
authors.lastname: Marshak
authors.forename: Hildemar
authors.initials: H
authors.lastname: Dos Santos
authors.forename: Sen M
authors.initials: SM
authors.lastname: Luu
authors.forename: Lee S
authors.initials: LS
authors.lastname: Berk
authors.forename: Paul T
authors.initials: PT
authors.lastname: McMahon
authors.forename: Matt
authors.initials: M
authors.lastname: Riggs
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*