title: AIDE-Acute Illness and Depression in Elderly Patients. Cognitive Behavioral Group Psychotherapy in Geriatric Patients With Comorbid Depression: A Randomized, Controlled Trial.
abstract: BACKGROUND
  Comorbid depression is highly prevalent in geriatric patients and associated with functional loss, frequent hospital re-admissions, and a higher mortality rate. Cognitive behavioral psychotherapy (CBT) has shown to be effective in older depressive patients living in the community. To date, CBT has not been applied to older patients with acute physical illness and comorbid depression.
  
  
  OBJECTIVE
  To evaluate the effectiveness of CBT in depressed geriatric patients, hospitalized for acute somatic illness.
  
  
  METHODS
  Randomized controlled trial with waiting list control group.
  
  
  METHODS
  Postdischarge intervention in a geriatric day clinic; follow-up evaluations at the patients' homes.
  
  
  METHODS
  A total of 155 randomized patients, hospitalized for acute somatic illness, aged 82 ± 6 years and suffering from depression [Hospital Anxiety and Depression Scale (HADS) scores >7]. Exclusion criteria were dementia, delirium, and terminal state of medical illness.
  
  
  METHODS
  Fifteen, weekly group sessions based on a CBT manual. Commencement of psychotherapy immediately after discharge in the intervention group and a 4-month waiting list interval with usual care in the control group.
  
  
  METHODS
  HADS depression total score after 4 months. Secondary endpoints were functional, cognitive, psychosocial and physical status, resource utilization, caregiver burden, and amount of contact with physician.
  
  
  RESULTS
  The intervention group improved significantly in depression scores (HADS baseline 18.8; after 4 months 11.4), whereas the control group deteriorated (HADS baseline 18.1; after 4 months 21.6). Significant improvement in the intervention group, but not in the control group, was observed for most secondary outcome parameters such as the Barthel and Karnofsky indexes. Intervention effects were less pronounced in patients with cognitive impairment or acute fractures.
  
  
  CONCLUSIONS
  CBT is feasible and highly effective in geriatric patients. The benefits extend beyond effective recovery and include improvement in physical and functional parameters. Early diagnosis, good access to psychotherapy, and early intervention could improve care for depressive older patients.
  
  
  BACKGROUND
  www.germanctr.de German Trial Register DRKS 00004728.
authors.affiliation: Geriatric and Gerontopsychotherapeutic Practice, Mannheim, Germany. Electronic address: praxis@geriatrie-rheinneckar.de.
authors.forename: Jana
authors.initials: J
authors.lastname: Hummel
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Weisbrod
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Leila
authors.initials: L
authors.lastname: Boesch
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Himpler
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hauer
authors.affiliation: University of Tuebingen, Tuebingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hautzinger
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaebel
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Tania
authors.initials: T
authors.lastname: Zieschang
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fickelscherer
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany.
authors.forename: Slawomira
authors.initials: S
authors.lastname: Diener
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Ilona
authors.initials: I
authors.lastname: Dutzi
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany.
authors.forename: Bertram
authors.initials: B
authors.lastname: Krumm
authors.affiliation: Geriatric Center Bethanien, Heidelberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Oster
authors.affiliation: Department of Geriatrics, Marien Hospital, Hamburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kopf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016638:Critical Illness; D003863:Depression; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011613:Psychotherapy; D011615:Psychotherapy, Group; D012720:Severity of Illness Index
keywords: Depression; cognitive behavioral therapy; comorbidity; geriatric; old age; psychotherapy