title: Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.
abstract: The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai.
  
  
  
  Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects.
  
  
  
  There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups in terms of sleep, well-being, and depression at baseline and before the intervention. Mixed-model repeated measures ANOVAs detected a group × time interaction on depression, sleep, and well-being and showed a favorable intervention effect within groups immediately after the intervention.
  
  
  
  The mutual recovery program could be a creative and effective approach to improve mental health in older community-dwelling adults with depressive symptom.
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.|National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.|Suzhou Center for Disease Control and Prevention, Suzhou, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Hua
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Fu
authors.affiliation: Chongqing Center for Disease Prevention and Control, Chongqing, China.
authors.forename: Longfeng
authors.initials: L
authors.lastname: Cheng
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Qian
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.
authors.forename: Junyang
authors.initials: J
authors.lastname: Liu
authors.affiliation: School of Nursing, Midwifery and Physiotherapy, The University of Nottingham, Nottingham, UK.|Professorial Fellow at the Institute of Mental Health, Nottingham University, Nottingham, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Crawford
authors.affiliation: School of Public Health, Health Communication Institute, Fudan University, Shanghai, China. jmdai@fudan.edu.cn.
authors.forename: Junming
authors.initials: J
authors.lastname: Dai
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology; D000704:Analysis of Variance; D002681:China; D003863:Depression / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010865:Pilot Projects; D012111:Residence Characteristics; D012890:Sleep; D012893:Sleep Wake Disorders / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Depression; Elderly population; Intervention; Mental health; Well-being