medigraphic.com
SPANISH

Salud Mental

ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2015, Number 1

<< Back Next >>

Salud Mental 2015; 38 (1)

Clinical effectiveness of group cognitivebehavioural therapy for depressed older people in primary care: A randomised controlled trial

García-Peña C, Vázquez-Estupiñan F, Avalos-Pérez F, Robles JLV, Sánchez-Garcia S, Juárez-Cedillo T
Full text How to cite this article

Language: English
References: 27
Page: 33-39
PDF size: 245.08 Kb.


Key words:

Elderly, depression, cognitive therapy.

ABSTRACT

Background Depression is associated with an increased use of medical resources and reduced quality of life, cognitive functions, functionality and general health. The treatment of depression is limited by the scarcity of mental health professionals, as reflected in the mental health atlas of the World Health Organization.
Method A randomised controlled trial that was not blinded was conducted. Family doctors referred patients older than 60 years who were suspected to have depression to the screening module. The PHQ-9 questionnaire, the Six-Item Screener, and previous diagnosis for psychiatric disorders were collected. Major depression was excluded. Those with a score from two to six on the PHQ-9 and with no comorbidities were referred to the Baseline Phase. A simple random process without blocking was applied. Groups of 7-10 participants engaged in weekly sessions over the course of three months. The control group was referred to their family physician. Reduction in depression score of the PHQ-9 was the main outcome.
Results and discussion There were 40 patients in the control group (CG) and 41 in the intervention group (IG). 84% were women, 41% married and 41% reported at least primary education. The mean age for the GC was 69.7 years vs. 71.3 in the GI. The baseline mean MMSE score was 23.7 in the GC and 24.1 in the IG. No significant baseline differences between groups were reported. In the IG, 56% of the participants (n=23) displayed a decrease that was greater than or equal to 5 points on the PHQ-9 compared with 30% (n=12) in the control group. The CT group evidenced a marginal improvement.


REFERENCES

  1. Gallo JJ, Lebowitz BD. The epidemiology of common late-life mental disorders in the community: Themes for the new century. Psychiat Serv 1999;50:1158-1168.

  2. Wagner FA, Gallo JJ, Delva J. Depression in late life: A hidden public health for Mexico? Salud Pública Mex 1999;41:189-202.

  3. Medina-Mora ME, Rascón ML, Tapia R, Mariño M et al. Trastornos emocionales en población urbana mexicana: resultados de un estudio nacional. An Inst Mex Psiquiatr 1992;3:48-55.

  4. Caraveo J, Martínez N, Rivera B, Polo A. Prevalencia en la vida de episodios depresivos y utilización de servicios especializados. Salud Mental 1997;20:15-23.

  5. García-Peña C, Wagner FA, Sánchez-Garcia S, Juárez-Cedillo T et al. Depressive symptoms among older adults in Mexico City. J Gen Intern Med 2008;12:1973-1980.

  6. Lapid M, Rummans T. Evaluation and management of geriatric depression in primary care. Mayo Clin Proccedings 2003;78:1423-1429.

  7. Beekman A, Deeg D, Braam A, Smit J et al. Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychol Med 1997;27:1397-1409.

  8. Prince M, Patel V, Saxena S, Maj M et al. No health without mental health. Lancet 2007;370:859-77.

  9. World Health Organization. Mental health Atlas. Geneva: WHO Press; 2005.

  10. Mottram PG, Wilson K, Strobl JJ. Antidepressants for depressed elderly. Cochrane Database Syst Rev 2006;25: CD003491.

  11. Cuijpers P, Muñoz R, Clarke GN, Lewinsohn PM. Psychoeducational treatment and prevention of depression: The “coping with depression” course thirty years later. Clin Psychol Rev 2009;29:449–458.

  12. Katon WJ, Schoenbaum M, Fan MY, Callahan CM et al. Cost-effectiveness of improving primary care, treatment of late-life depression. Arch Gen Psychiatry 2005;62:1313-1320.

  13. Serfaty M, Haworth D, Blanchard M, Buszewicz M et al. Clinical effectiveness of individual cognitive behavioral therapy for depressed older people in primary care a randomized controlled trial. Arch Gen Psychiatry 2009;66:1332-1340.

  14. Kroenke K, Sptizer R, Williams J. The PHQ 9 valdity of a brief depression severity measure. J Gen Int Med 2001:16:606-613.

  15. Pinto-Meza A, Serrano-Blanco A, Peñarrubia MT, Blanco E et al. Assessing depression in primary care with the PHQ-9: Can it be carried out over the telephone? J Gen Int Med 2005;20:738–742.

  16. Spitzer R, Kroenke K, Williams J et al. Validation and utility of a selfreport version of PRIME-MD: The PHQ primary care study. JAMA 1999;282(18):1737-1744.

  17. Callaham C, Unverzagt F, Hui SL, Perkins A et al. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care 2002;40:771-781.

  18. Reyes de Beaman S, Beaman P, García-Peña C, Villa MA et al. Validation of a modified version of the Mini-Mental State Examination (MMSE) in Spanish. Aging Neuropsychol Cognition 2004;11:1-11.

  19. Muñoz RF, Aguilar-Gaxiola S, Guzmán J. Manual de terapia de grupo para el tratamiento cognitivo-conductual de depresión. Santa Monica: The RAND Corporation; 2000.

  20. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992;30:473-483.

  21. Zuñiga MA, Carrillo-Jimenez GT, Fox PJ, Gandek B et al. Evaluación del estado de salud con la Encuesta SF-36: resultados preliminares. Salud Publica Méx 1999;41:110-118.

  22. Hays RD, Sherbourne CD. RAND 36-Item health Survey 1.0 Scoring Manual. Santa Monica, CA: The RAND Corporation; 1992.

  23. Lehtonen R, Pahkinen E. Practical methods for design and analysis of complex surveys (statistics in practice). 2nd Ed. West Sussex: John Wiley & Sons LTD; 2004.

  24. Sinoff G, Ore L, Zlotogorsky D, Tamir D. Short anxiety screening test- a brief instrument for detecting anxiety in the elderly. Int J Geriat Psychiat 1999;14:1062-1710.

  25. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-383.

  26. Rowan PJ, Davidson K, Campbell JA, Dobrez DG et al. Depressive symptoms predict medical care utilization in a population-based sample. Psychol Med 2002;32:903-908.

  27. Gallo JJ, Bogner HR, Morales KH, Post EP et al. The effect of a primary care practice-based depression intervention on mortality in older adults. Ann Intern Med 2007;146:689-698.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Salud Mental. 2015;38