Chang Ki Jung, Hong Chang Hyung, Roh Hyun Woong, Lee Kang Soo, Lee Eun Hee, Kim Jinju, Lim Hyun Kook, Son Sang Joon
Department of Psychiatry, Ajou Good Hospital, Suwon, Republic of Korea.
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Psychiatry Investig. 2018 Mar;15(3):279-284. doi: 10.30773/pi.2017.08.10. Epub 2018 Feb 22.
The objective of this study was to compare the effectiveness of usual care management (UCM) and a newly-developed lifestyle modification with contingency management (LMCM) for geriatric depressive symptoms in the community.
A randomized controlled trial was conducted in 93 older adults with major depressive disorder at community mental health centers. A 12 week multi-domain LMCM was developed by providing positive reinforcement using 'gold medal stickers' as a symbolic incentive to motivate their participation and adherence. Participants were allocated to LMCM (n=47) and UCM (n=46) groups. They were then subjected to the 12 week treatment. Effects of the two intervention methods on Geriatric Depression Scale were determined using mixed model analysis.
Participants in the LMCM group had greater decline in GDS score per month than participants in the UCM group after adjusting for age, sex, years of education, living alone, and MMSE scores at baseline examination [coefficient for GDS score (95% CI): -1.08 (-1.51, -0.65), p<0.001, reference: UCM group].
LMCM is safe and easy to use with a low cost. LMCM is suitable as psychosocial intervention for older adults with depressive symptoms in the community.
本研究旨在比较常规护理管理（UCM）和新开发的生活方式改变与应急管理（LMCM）对社区老年抑郁症状的有效性。
在社区心理健康中心对93名患有重度抑郁症的老年人进行了一项随机对照试验。通过使用“金牌贴纸”作为象征性激励措施提供积极强化，以激励他们参与和坚持，从而开发了一种为期12周的多领域LMCM。参与者被分配到LMCM组（n = 47）和UCM组（n = 46）。然后他们接受为期12周的治疗。使用混合模型分析确定两种干预方法对老年抑郁量表的影响。
在调整年龄、性别、受教育年限、独居情况以及基线检查时的简易精神状态检查表（MMSE）分数后，LMCM组参与者每月的老年抑郁量表（GDS）得分下降幅度大于UCM组参与者[GDS得分系数（95%置信区间）：-1.08（-1.51，-0.65），p<0.001，参照：UCM组]。
LMCM安全且易于使用，成本较低。LMCM适合作为社区中患有抑郁症状老年人的心理社会干预措施。
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