Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
PLoS One. 2020 Apr 1;15(4):e0230770. doi: 10.1371/journal.pone.0230770. eCollection 2020.
Little is known about community-based interventions for geriatric depression in low-resource settings. This study assessed the effectiveness of 3-month-duration interventions with peer counseling, social engagement, and combination vs. control in improving depressive symptoms of community-dwelling Filipino senior citizens.
We conducted an open (non-blinded), non-randomized trial of senior citizens at risk for depression. Three different 3-month interventions included peer counseling (n = 65), social engagement (n = 66), and combination (n = 65) were compared with the control group (n = 68). We assessed geriatric depression, psychological resilience, perceived social support, loneliness, and working alliance scores at baseline and three months after the intervention. This trial was registered with ClinicalTrials.gov, identifier: NCT03989284.
Geriatric depression score over three months significantly improved in all intervention groups (control as reference). Significant improvements were also seen in psychological resilience and social support. Not all interventions, however, significantly improved the loneliness score. The combination group showed the largest effect of improving depressive symptoms (d = -1.33) whereas the social engagement group showed the largest effect of improving psychological resilience (d = 1.40), perceived social support (d = 1.07), and loneliness (d = -0.36) among senior citizens.
At the community level, peer counseling, social engagement, and combination interventions were effective in improving depressive symptoms, psychological resilience, and social support among Filipino senior citizens. This study shows that it is feasible to identify senior citizens at risk for depression in the community and intervene effectively to improve their mental health. Further studies are required to target loneliness and investigate the long-term benefits of the interventions.
ClinicalTrials.gov: NCT03989284.
在资源匮乏的环境中,针对老年抑郁症的社区干预措施知之甚少。本研究评估了为期 3 个月的同伴咨询、社会参与和联合干预与对照组相比,改善菲律宾社区居住的老年公民抑郁症状的效果。
我们对有抑郁风险的老年患者进行了一项开放性(非盲法)、非随机试验。三种不同的 3 个月干预措施包括同伴咨询(n=65)、社会参与(n=66)和联合干预(n=65),与对照组(n=68)进行了比较。我们在基线和干预 3 个月后评估了老年抑郁、心理弹性、感知社会支持、孤独感和工作联盟评分。这项试验在 ClinicalTrials.gov 上注册,标识符为:NCT03989284。
所有干预组的老年抑郁评分在三个月内均显著改善(以对照组为参照)。心理弹性和社会支持也有显著改善。然而,并非所有干预都显著改善了孤独感评分。联合干预组改善抑郁症状的效果最大(d=-1.33),而社会参与组改善心理弹性(d=1.40)、感知社会支持(d=1.07)和孤独感(d=-0.36)的效果最大。
在社区层面,同伴咨询、社会参与和联合干预措施可有效改善菲律宾老年公民的抑郁症状、心理弹性和社会支持。这项研究表明,在社区中识别有抑郁风险的老年人并进行有效的干预以改善他们的心理健康是可行的。需要进一步的研究来针对孤独感,并探讨干预措施的长期效果。
ClinicalTrials.gov:NCT03989284。