title: Psychosocial interventions with art, music, Tai Chi and mindfulness for subsyndromal depression and anxiety in older adults: A naturalistic study in Singapore.
abstract: OBJECTIVE
  Subsyndromal depression (SSD) and subsyndromal anxiety (SSA) are common in the elderly and if left untreated, contributes to a lower quality of life, increased suicide risk, disability and inappropriate use of medical services. Innovative approaches are necessary to address this public health concern. We evaluate a community-based psychosocial intervention program and its effect on mental health outcomes in Singaporean older adults.
  
  
  METHODS
  Elderly participants with SSD and SSA, as assessed on the Geriatric Depression Scale and Geriatric Anxiety Inventory, were included. Intervention groups include Tai Chi exercise, Art Therapy, Mindfulness Awareness Practice and Music Reminiscence Therapy. The program was divided into a single intervention phase and a combination intervention phase. Outcomes were measured with the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) at baseline, 4 weeks, 10 weeks, 24 weeks and 52 weeks. The program had ethics board approval.
  
  
  RESULTS
  A hundred and one subjects (25 males, 76 females; mean age = 71 years, SD = 5.95) participated. There were significant reductions in SDS and SAS scores in the single intervention phase (P < 0.05), and these reductions remained significant at week 52, after completion of the combination intervention phase, relative to baseline (P < 0.001).
  
  
  CONCLUSIONS
  Participating in these psychosocial interventions led to a positive improvement in SSD and SSA symptoms in these elderly subjects over a year. This simple, inexpensive and culturally acceptable approach should be adequately studied and replicated in other communities.
authors.affiliation: Department of Psychological Medicine, National University Hospital, Singapore.
authors.forename: Iris
authors.initials: I
authors.lastname: Rawtaer
authors.affiliation: Department of Psychological Medicine, National University Hospital, Singapore.|Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Rathi
authors.initials: R
authors.lastname: Mahendran
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Junhong
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Psychological Medicine, National University Hospital, Singapore.|Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Johnson
authors.initials: J
authors.lastname: Fam
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Psychological Medicine, National University Hospital, Singapore.|Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D001155:Art Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D009147:Music Therapy / Q000379:methods*; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D026302:Tai Ji / Q000379:methods*; D016896:Treatment Outcome
keywords: Asia; anxiety; community; depression; elderly