Department of Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Medical College of Cornell University, New York, NY, USA.
Am J Geriatr Psychiatry. 2010 Nov;18(11):988-98. doi: 10.1097/JGP.0b013e3181d6947d.
This preliminary study examines the efficacy of 12-week home-delivered problem adaptation therapy (PATH) versus home-delivered supportive therapy (ST) in reducing depression and disability in 30 depressed, cognitively impaired, disabled older adults.
A 12-week randomized clinical trial. Research assistants were unaware of the participants' randomization status. Assessments were conducted at baseline, 6 weeks, and 12 weeks.
Weill-Cornell Advanced Center for Interventions and Services Research.
Thirty elders with major depression, cognitive impairment, and disability were recruited through advertisement and the Home-Delivered Meals Program of the Westchester County Department of Senior Programs and Services.
PATH is a home-delivered intervention designed to reduce depression and disability in depressed, cognitively impaired, disabled elders. PATH is based on problem-solving therapy and integrates environmental adaptation and caregiver participation. PATH is consistent with Lawton's ecologic model of adaptive functioning in aging.
Depression and disability were measured with Hamilton Depression Rating Scale-24 items and Sheehan Disability Scale, respectively. Client Satisfaction Questionnaire was used to assess patient satisfaction with treatment.
Mixed-effects model analyses revealed that PATH was more efficacious than ST in reducing depression and disability at 12 weeks. Participants in both treatment groups were satisfied with treatment.
This preliminary study suggests that PATH is well accepted and efficacious in depressed elders with major depression, cognitive impairment, and disability. Because this population may not adequately respond to antidepressant medication treatment, PATH may provide relief to many patients who would otherwise remain depressed and continue to suffer.
本初步研究旨在检验为期 12 周的家庭式问题适应疗法（PATH）与家庭式支持性疗法（ST）在降低 30 名抑郁、认知障碍、残疾老年患者的抑郁和残疾程度方面的疗效。
12 周随机临床试验。研究助理不了解参与者的随机分组情况。评估在基线、6 周和 12 周进行。
康奈尔-Weill 高级干预与服务研究中心。
通过广告和威彻斯特县老年人项目和服务部的家庭送餐计划招募了 30 名患有重度抑郁症、认知障碍和残疾的老年人。
PATH 是一种家庭式干预措施，旨在降低抑郁、认知障碍、残疾的老年患者的抑郁和残疾程度。PATH 基于问题解决疗法，并整合了环境适应和照顾者参与。PATH 符合 Lawton 衰老适应性功能的生态模型。
使用 Hamilton 抑郁评定量表-24 项和 Sheehan 残疾量表分别测量抑郁和残疾程度。使用客户满意度问卷评估患者对治疗的满意度。
混合效应模型分析显示，在 12 周时，PATH 比 ST 更能有效降低抑郁和残疾程度。两组治疗的参与者均对治疗感到满意。
本初步研究表明，PATH 深受患有重度抑郁症、认知障碍和残疾的老年患者的欢迎且有效。由于这一人群可能无法充分响应抗抑郁药物治疗，因此 PATH 可能为许多否则会继续抑郁和痛苦的患者提供缓解。
