Konnert Candace, Dobson Keith, Stelmach Liza
Psychology, University of Calgary, Calgary, Alberta, Canada.
Aging Ment Health. 2009 Mar;13(2):288-99. doi: 10.1080/13607860802380672.
The prevention of depression in individuals who are at risk is important for affected individuals, their family members, and for society at large. This study presents the results of a randomized clinical trial aimed at the prevention of depression in nursing home residents. Residents were screened with the Geriatric Depression Scale (GDS) and a diagnostic interview. Those with elevated GDS scores who did not meet diagnostic criteria for depression were randomly assigned to a treatment or control (treatment as usual, TAU) condition. The treatment was an adaptation of the Coping with Stress program developed by Clarke et al. (1995; Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312-321), and focused on various components typical of cognitive-behavioral treatment (CBT) programs (e.g. increasing pleasant events, reducing negative cognitions). Both groups were assessed on measures of depression before treatment, after treatment, and at 3- and 6-month follow-up points. Compared with the TAU group, residents receiving the intervention showed considerable improvement over the 6-month follow-up on the GDS. Average scores on the GDS, for example, went from 14.0 to 9.4 in the CBT group over the course of treatment and follow-up, vs. scores from 13.4 to 12.3 for the TAU group over the same time. However, results on the Center for Epidemiological Studies Depression Scale at 3 months were nonsignificant. Overall, the results of this study suggest that a brief, group-based CBT program can have significant benefit in nursing home residents at risk for depression.
对于处于抑郁风险中的个体、其家庭成员以及整个社会而言，预防抑郁都非常重要。本研究呈现了一项旨在预防养老院居民抑郁的随机临床试验结果。使用老年抑郁量表（GDS）和诊断访谈对居民进行筛查。GDS得分升高但未达到抑郁诊断标准的居民被随机分配到治疗组或对照组（常规治疗，TAU）。治疗方案是对Clarke等人（1995年；《美国儿童与青少年精神病学会杂志》，34卷，312 - 321页）开发的应对压力项目的改编，重点关注认知行为治疗（CBT）项目的各种典型组成部分（例如增加愉快事件、减少消极认知）。在治疗前、治疗后以及3个月和6个月的随访点，对两组进行抑郁测量评估。与TAU组相比，接受干预的居民在6个月随访期间，GDS得分有显著改善。例如，在治疗和随访过程中，CBT组的GDS平均得分从14.0降至9.4，而TAU组在同一时期的得分从13.4降至12.3。然而，3个月时在流行病学研究中心抑郁量表上的结果无显著差异。总体而言，本研究结果表明，一个简短的、基于团体的CBT项目对有抑郁风险的养老院居民可能有显著益处。
