Moore Raeanne C, Chattillion Elizabeth A, Ceglowski Jennifer, Ho Jennifer, von Känel Roland, Mills Paul J, Ziegler Michael G, Patterson Thomas L, Grant Igor, Mausbach Brent T
Department of Psychiatry, University of California, San Diego, USA; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, USA.
Behav Res Ther. 2013 Oct;51(10):623-32. doi: 10.1016/j.brat.2013.07.005. Epub 2013 Jul 19.
Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.
痴呆症护理与抑郁症状加剧以及心血管疾病（CVD）风险增加有关。本研究评估了愉悦事件计划（PEP）的疗效，这是一项为期6周的行为激活干预措施，旨在降低护理人员患心血管疾病的风险和抑郁症状。100名痴呆症家庭护理人员被随机分为6周的PEP干预组（N = 49）或时间相当的信息支持（IS）对照组（N = 51）。在干预前后以及1年随访时完成评估。生物学评估包括心血管疾病风险标志物白细胞介素-6（IL-6）和D-二聚体。心理社会结果包括抑郁症状、积极情绪和消极情绪。接受PEP干预的参与者从治疗前到治疗后，IL-6（p = 0.040）、抑郁症状（p = 0.039）和消极情绪（p = 0.021）的减少幅度显著更大。对于IL-6，20.0%的PEP参与者和6.5%的IS参与者出现了临床上的显著改善。对于抑郁症状，32.7%的PEP参与者与11.8%的IS参与者出现了临床上的显著改善。从基线到1年随访的变化中，所有结果的组间差异均无统计学意义。PEP计划降低了老年痴呆症护理人员的抑郁水平，并改善了一项生理健康指标。未来的研究应检验PEP对改善其他心血管疾病生物标志物的疗效，并寻求维持干预效果。
