DiNapoli Elizabeth A, Pierpaoli Christina M, Shah Avani, Yang Xin, Scogin Forrest
a VA Pittsburgh Healthcare System , Pittsburgh , Pennsylvania , USA.
b University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA.
Clin Gerontol. 2017 May-Jun;40(3):181-190. doi: 10.1080/07317115.2017.1288670. Epub 2017 Feb 1.
We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults.
This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R).
Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment.
Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations.
Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults.
我们在一个种族多样化、资源匮乏且身体虚弱的农村老年人群样本中，研究了上门提供的抑郁症认知行为疗法（CBT）对焦虑症状的影响。
这是一项对随机临床试验的二次分析，该试验涉及134名65岁及以上、生活质量下降且心理症状加重的农村成年人。使用症状自评量表90修订版（SCL - 90 - R）的焦虑和恐惧焦虑分量表评估焦虑症状。
与最低限度支持的对照条件相比，抑郁症的CBT治疗从治疗前到治疗后在焦虑和恐惧焦虑症状方面带来了显著更大的改善。
上门提供的抑郁症CBT治疗对于难以接触到的老年人群中的焦虑症可能是一种有效的治疗方法。
进一步的研究应探索综合焦虑和抑郁方案以及其他治疗方式，包括认知行为疗法的阅读疗法或远程医疗模式，以降低上门提供治疗相关的成本。对于脆弱的农村老年人，可能需要在管理上具有灵活性并对CBT方案进行调整。
