title: Treatment Considerations for Depression Research in Older Married Couples: A Dyadic Case Study.
abstract: OBJECTIVE
  Critical gaps remain in understanding optimal approaches to intervening with older couples. The focus of this report is to describe the pros and cons of incorporating spousal dyads into depression-prevention research.
  
  
  METHODS
  In an intervention development study, the authors administered problem-solving therapy (PST) dyadically to participants with mild cognitive impairment (MCI) and their caregivers. Dyads worked with the same interventionist in the same therapy session. The dyadic PST (highlighted in a case example of a husband with MCI and his wife/support person) and the potential feasibility of the program are described.
  
  
  RESULTS
  The authors found that the wife of the individual with MCI could be trained as a PST coach to help her husband learn and use problem-solving skills. A decrease in depressive symptom severity was observed for the individual with MCI, which was sustained over 12 months of follow-up. Neither the husband nor wife experienced an incident episode of major depression over the course of the study.
  
  
  CONCLUSIONS
  Dyadic interventions need to be further developed in geriatric psychiatry; proven methods such as PST can be modified to include patients' support persons. Recommendations are offered for developing randomized controlled trials that aim to recruit dyads and prevent depression in at-risk older married couples.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Stahl
authors.affiliation: Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA.
authors.forename: Juleen
authors.initials: J
authors.lastname: Rodakowski
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Ariel G
authors.initials: AG
authors.lastname: Gildengers
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.affiliation: Department of Counseling Psychology, Chatham University, Pittsburgh, PA.
authors.forename: Jennifer Q
authors.initials: JQ
authors.lastname: Morse
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rico
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ButtersMA@upmc.edu.
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
mesh_terms: D000368:Aged; D017028:Caregivers; D060825:Cognitive Dysfunction / Q000628:therapy*; D000072466:Cognitive Remediation / Q000379:methods*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving / Q000502:physiology*; D018454:Spouses
keywords: Depression; couples; dyads; prevention; problem-solving therapy